Know Your Epidemic, Strengthen Your Response: Developing a New HIV Surveillance Architecture to Guide HIV Resource Allocation and Target Decisions

PubMed Central

Sanchez, Travis; Baral, Stefan; Mee, Paul; Sabin, Keith; Garcia-Calleja, Jesus M; Hargreaves, James

2018-01-01

To guide HIV prevention and treatment activities up to 2020, we need to generate and make better use of high quality HIV surveillance data. To highlight our surveillance needs, a special collection of papers in JMIR Public Health and Surveillance has been released under the title “Improving Global and National Responses to the HIV Epidemic Through High Quality HIV Surveillance Data.” We provide a summary of these papers and highlight methods for developing a new HIV surveillance architecture. PMID:29444766

Integrating HIV Surveillance and Field Services: Data Quality and Care Continuum in King County, Washington, 2010-2015.

PubMed

Hood, Julia E; Katz, David A; Bennett, Amy B; Buskin, Susan E; Dombrowski, Julia C; Hawes, Stephen E; Golden, Matthew R

2017-12-01

To assess how integration of HIV surveillance and field services might influence surveillance data and linkage to care metrics. We used HIV surveillance and field services data from King County, Washington, to assess potential impact of misclassification of prior diagnoses on numbers of new diagnoses. The relationship between partner services and linkage to care was evaluated with multivariable log-binomial regression models. Of the 2842 people who entered the King County HIV Surveillance System in 2010 to 2015, 52% were newly diagnosed, 41% had a confirmed prior diagnosis in another state, and 7% had an unconfirmed prior diagnosis. Twelve percent of those classified as newly diagnosed for purposes of national HIV surveillance self-reported a prior HIV diagnosis that was unconfirmed. Partner services recipients were more likely than nonrecipients to link to care within 30 days (adjusted risk ratio [RR] = 1.10; 95% confidence interval [CI] = 1.03, 1.18) and 90 days (adjusted RR = 1.07; 95% CI = 1.01, 1.14) of diagnosis. Integration of HIV surveillance, partner services, and care linkage efforts may improve the accuracy of HIV surveillance data and facilitate timely linkage to care.

Revised surveillance case definition for HIV infection--United States, 2014.

PubMed

2014-04-11

Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged <13 years). The revisions were made to address multiple issues, the most important of which was the need to adapt to recent changes in diagnostic criteria. Laboratory criteria for defining a confirmed case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

Improving HIV Surveillance Among Transgender Populations in Tennessee.

PubMed

Sizemore, Lindsey A; Rebeiro, Peter F; McGoy, Shanell L

2016-06-01

HIV prevalence and outcome disparities among sexual and gender minorities are profound in the United States. Tennessee HIV surveillance practices have not been uniform for transgender status, although data collection capabilities exist. We, therefore, describe current reporting of data on transgender individuals in Tennessee to identify targets for improvement. Data for all HIV-diagnosed individuals living in Tennessee as of December 31, 2013, were extracted from the Enhanced HIV/AIDS Reporting System (eHARS). The birth_sex ("Male" or "Female") and current_gender ("Male," "Female," "Male-to-Female," "Female-to-Male," or "Additional Gender Identity") variables were examined, and proportion missing current_gender data by region was ascertained. Transgender individuals were defined as having different birth_sex and current_gender values. To ensure the protection of health information, data were cleaned, deidentified, and aggregated using Statistical Analysis Software (SAS) Version 9.3 (SAS Institute, Inc., Cary, NC). Among 16,063 HIV-diagnosed individuals in Tennessee, 27 were transgender: 52% (n = 14) with "Male-to-Female," 26% (n = 7) with "Female," and 22% (n = 6) with "Male" as their current_gender values. Proportions missing current_gender differed significantly by region across Tennessee (global, P < 0.01). While HIV-positive transgender individuals should be recognized as integral members of the LGBT community, they should also be acknowledged as a separate subgroup when appropriate. Collecting information about current self-identified gender identity should no longer be optional in Tennessee HIV surveillance. Although making efforts to collect both birth_sex and current_gender mandatory with each interview will improve surveillance, it is critical to train all staff properly on the correct way to inquire about gender identity in a culturally sensitive manner. Revamping data collection methods will not only improve inconsistent methods currently

Improving HIV Surveillance Among Transgender Populations in Tennessee

PubMed Central

Rebeiro, Peter F.; McGoy, Shanell L.

2016-01-01

Abstract Purpose: HIV prevalence and outcome disparities among sexual and gender minorities are profound in the United States. Tennessee HIV surveillance practices have not been uniform for transgender status, although data collection capabilities exist. We, therefore, describe current reporting of data on transgender individuals in Tennessee to identify targets for improvement. Methods: Data for all HIV-diagnosed individuals living in Tennessee as of December 31, 2013, were extracted from the Enhanced HIV/AIDS Reporting System (eHARS). The birth_sex (“Male” or “Female”) and current_gender (“Male,” “Female,” “Male-to-Female,” “Female-to-Male,” or “Additional Gender Identity”) variables were examined, and proportion missing current_gender data by region was ascertained. Transgender individuals were defined as having different birth_sex and current_gender values. To ensure the protection of health information, data were cleaned, deidentified, and aggregated using Statistical Analysis Software (SAS) Version 9.3 (SAS Institute, Inc., Cary, NC). Results: Among 16,063 HIV-diagnosed individuals in Tennessee, 27 were transgender: 52% (n = 14) with “Male-to-Female,” 26% (n = 7) with “Female,” and 22% (n = 6) with “Male” as their current_gender values. Proportions missing current_gender differed significantly by region across Tennessee (global, P < 0.01). Conclusion: While HIV-positive transgender individuals should be recognized as integral members of the LGBT community, they should also be acknowledged as a separate subgroup when appropriate. Collecting information about current self-identified gender identity should no longer be optional in Tennessee HIV surveillance. Although making efforts to collect both birth_sex and current_gender mandatory with each interview will improve surveillance, it is critical to train all staff properly on the correct way to inquire about gender identity in a culturally sensitive manner

Association Between Enacted Stigma and HIV-Related Risk Behavior Among MSM, National HIV Behavioral Surveillance System, 2011.

PubMed

Balaji, Alexandra B; Bowles, Kristina E; Hess, Kristen L; Smith, Justin C; Paz-Bailey, Gabriela

2017-01-01

MSM bear a disproportionate burden of the HIV epidemic. Enacted stigma (overt negative actions) against sexual minorities may play an important role in increasing HIV risk among this population. Using data from the 2011 National HIV Behavioral Surveillance system, MSM cycle, we examined the independent associations between three measures of enacted stigma (verbal harassment, discrimination, physical assault) and engagement in each of four HIV-related risk behaviors as outcomes: condomless anal intercourse (CAI) at last sex with a male partner of HIV discordant or unknown status and, in the past 12 months, CAI with a male partner, ≥4 male sex partners, and exchange sex. Of 9819 MSM, 32% experienced verbal harassment in the past 12 months, 23% experienced discrimination, and 8% experienced physical assault. Discordant CAI at last sex with a male partner was associated with previous discrimination and physical assault. Past 12 month CAI with a male partner, ≥4 male sex partners, and exchange sex were each associated with verbal harassment, discrimination, and physical assault. These findings indicate that a sizable proportion of MSM report occurrences of past 12 month enacted stigma and suggest that these experiences may be associated with HIV-related risk behavior. Addressing stigma towards sexual minorities must involve an integrated, multi-faceted approach, including interventions at the individual, community, and societal level.

DEFENSE MEDICAL SURVEILLANCE SYSTEM (DMSS)

EPA Science Inventory

AMSA operates the Defense Medical Surveillance System (DMSS), an executive information system whose database contains up-to-date and historical data on diseases and medical events (e.g., hospitalizations, ambulatory visits, reportable diseases, HIV tests, acute respiratory diseas...

Innovations in health and demographic surveillance systems to establish the causal impacts of HIV policies.

PubMed

Herbst, Kobus; Law, Matthew; Geldsetzer, Pascal; Tanser, Frank; Harling, Guy; Bärnighausen, Till

2015-11-01

Health and demographic surveillance systems (HDSS), in conjunction with HIV treatment cohorts, have made important contributions to our understanding of the impact of HIV treatment and treatment-related interventions in sub-Saharan Africa. The purpose of this review is to describe and discuss innovations in data collection and data linkage that will create new opportunities to establish the impacts of HIV treatment, as well as policies affecting the treatment cascade, on population health and economic and social outcomes. Novel approaches to routine collection of biomarkers, behavioural data, spatial data, social network information, migration events and mobile phone records can significantly strengthen the potential of HDSS to generate exposure and outcome data for causal analysis of HIV treatment impact and policies affecting the HIV treatment cascade. Additionally, by linking HDSS data to health service administration, education and welfare service records, researchers can substantially broaden opportunities to establish how HIV treatment affects health and economic outcomes when delivered through public sector health systems and at scale. As the HIV treatment scaleup in sub-Saharan Africa enters its second decade, it is becoming increasingly important to understand the long-term causal impacts of large-scale HIV treatment and related policies on broader population health outcomes, such as noncommunicable diseases, as well as on economic and social outcomes, such as family welfare and children's educational attainment. By collecting novel data and linking existing data to public sector records, HDSS can create near-unique opportunities to contribute to this research agenda.

Transitioning from antenatal surveillance surveys to routine HIV testing: a turning point in the mother-to-child transmission prevention programme for HIV surveillance in Brazil.

PubMed

Pereira, Gerson Fernando Mendes; Sabidó, Meritxell; Caruso, Alessandro; Benzaken, Adele Schwartz

2017-07-05

In Brazil, due to the rapid increase in programmes for the prevention of mother-to-child transmission (PMTCT), routine programme data are widely available. The objective of this study was to assess the utility of programmatic data to replace HIV surveillance based on the antenatal care (ANC) surveillance survey (SS). We analysed ANC SS data from 219 maternity service clinics. PMTCT variables were extracted from the ANC SS data collection form, which allowed us to capture and compare the ANC SS data and PMTCT HIV test results for each pregnant woman who completed the ANC SS. Both the PMTCT programme and the ANC SS tested for HIV using sequential ELISA and western blot for confirmation. We assessed the completeness (% missing) of the PMTC data included in the ANC SS. Of the 36,713 pregnant women who had ANC SS HIV tests performed, 30,588 also underwent PMTCT HIV testing. The HIV prevalence rate from routine PMTCT testing was 0.36%, compared to 0.38% from the ANC SS testing (relative difference -0.05%; absolute difference -0.02%). The relative difference in prevalence rates between pregnant women in northern Brazil and pregnant women central-west Brazil was -0.98 and 0.66, respectively. Of the 29,856 women who had HIV test results from both the PMTCT and ANC SS, the positive percent agreement of the PMTCT versus the surveillance test was 84.1% (95% confidence interval [CI]: 74.8-91.0), and the negative percent agreement was 99.9% (95% CI: 99.9-100.0). The PMTCT HIV testing uptake was 86.4%. The ANC SS HIV prevalence was 0.33% among PMTCT non-refusers and 0.59% among refusers, with a percent bias of -10.80% and a differential prevalence ratio of 0.56. Syphilis and HIV testing results were complete in 98% and 97.6% of PMTCT reports, respectively. The reported HIV status for the women at clinic entry was missing. Although there were consistent HIV prevalence estimates from the PMTCT data and the ANC SS, the overall positive percent agreement of 84.1% falls below the

Using Baltimore HIV behavioral surveillance data for local HIV prevention planning.

PubMed

German, Danielle; Linton, Sabriya; Cassidy-Stewart, Hope; Flynn, Colin

2014-04-01

In response to the National HIV/AIDS Strategy (NHAS) and as part of CDC's Enhanced Comprehensive HIV Prevention Plan (ECHPP) project, Maryland developed a comprehensive local HIV prevention plan for the Baltimore-Towson Metropolitan Statistical Area and identified a series of priority HIV prevention and service goals. The current project sought to: (1) determine how well National HIV Behavioral Surveillance (NHBS) indicators were aligned with NHAS/ECHPP-informed local HIV prevention goals (2) facilitate on-going NHBS data utilization to inform on-going local HIV prevention and service planning, and (3) build a foundation for future NHBS data utilization in local HIV decision-making. Project activities identified key HIV-related indicators in NHBS that are directly or indirectly related to local HIV priorities as informed by NHAS/ECHPP, which can be used for HIV prevention planning in the Baltimore area. Areas for enhancing NHBS and local data collection to further inform HIV prevention priorities are highlighted.

Cohort profile: the German ClinSurv HIV project--a multicentre open clinical cohort study supplementing national HIV surveillance.

PubMed

Bätzing-Feigenbaum, J; Kollan, C; Kühne, A; Matysiak-Klose, D; Gunsenheimer-Bartmeyer, B; Hamouda, O

2011-05-01

New forms of HIV/AIDS therapy require new surveillance instruments to meet shifting public health demands. The Clinical Surveillance of HIV Disease (ClinSurv HIV) project was established in 1999 as a collaboration between major HIV treatment centres in Germany and the Robert Koch Institute (RKI). The project contributes to national HIV surveillance and focuses on the changing epidemiology of HIV/AIDS after the introduction of new therapies in 1995. ClinSurv HIV is designed as an open multicentre observational cohort study of HIV-infected patients. Anonymized data on diagnoses, treatment and laboratory parameters are collected in a standardized format. Data are currently sampled biannually via 11 centres specializing in HIV diagnosis and care within the legal framework of the German Protection against Infection Act [Infektionsschutzgesetz (IfSG)]. A total of 14874 patients were enrolled in the study by 30 June 2009. Of these, 10221 patients (68.7%) were enrolled after 1 January 1999 and 6006 patients (40.4%) were known to have been diagnosed as positive for HIV before 1999. Evaluation indicators, such as the number of newly enrolled patients per half-year period, loss to follow-up, completeness of data per case, availability of data per possible clinical contact, and internal quality control parameters, show a very stable evolution in the cohort, which although open, can be observed. Comparison with the national HIV surveillance data suggests a high degree of representativeness according to major demographic variables. Bearing in mind the obvious strengths and weaknesses discussed, the German ClinSurv HIV cohort provides a broad range of research opportunities in the field of HIV/AIDS both within Germany and in international collaborative research.

Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009

PubMed Central

2013-01-01

Background Comparison of rates of newly diagnosed HIV infections among MSM across countries is challenging for a variety of reasons, including the unknown size of MSM populations. In this paper we propose a method of triangulating surveillance data with data collected in a pan-European MSM Internet Survey (EMIS) to estimate the sizes of the national MSM populations and the rates at which HIV is being diagnosed amongst them by calculating survey-surveillance discrepancies (SSD) as a measure of selection biases of survey participants. Methods In 2010, the first EMIS collected self-reported data on HIV diagnoses among more than 180,000 MSM in 38 countries of Europe. These data were compared with data from national HIV surveillance systems to explore possible sampling and reporting biases in the two approaches. The Survey-Surveillance Discrepancy (SSD) represents the ratio of survey members diagnosed in 2009 (HIVsvy) to total survey members (Nsvy), divided by the ratio of surveillance reports of diagnoses in 2009 (HIVpop) to the estimated total MSM population (Npop). As differences in household internet access may be a key component of survey selection biases, we analysed the relationship between household internet access and SSD in countries conducting consecutive MSM internet surveys at different time points with increasing levels of internet access. The empirically defined SSD was used to calculate the respective MSM population sizes (Npop), using the formula Npop = HIVpop*Nsvy*SSD/HIVsvy. Results Survey-surveillance discrepancies for consecutive MSM internet surveys between 2003 and 2010 with different levels of household internet access were best described by a potential equation, with high SSD at low internet access, declining to a level around 2 with broad access. The lowest SSD was calculated for the Netherlands with 1.8, the highest for Moldova with 9.0. Taking the best available estimate for surveillance reports of HIV diagnoses among MSM in 2009 (HIVpop

Participation Dynamics in Population-Based Longitudinal HIV Surveillance in Rural South Africa

PubMed Central

Larmarange, Joseph; Mossong, Joël; Bärnighausen, Till; Newell, Marie Louise

2015-01-01

Population-based HIV surveillance is crucial to inform understanding of the HIV pandemic and evaluate HIV interventions, but little is known about longitudinal participation patterns in such settings. We investigated the dynamics of longitudinal participation patterns in a high HIV prevalence surveillance setting in rural South Africa between 2003 and 2012, taking into account demographic dynamics. At any given survey round, 22,708 to 30,495 persons were eligible. Although the yearly participation rates were relatively modest (26% to 46%), cumulative rates increased substantially with multiple recruitment opportunities: 68% of eligible persons participated at least once, 48% at least twice and 31% at least three times after five survey rounds. We identified two types of study fatigue: at the individual level, contact and consent rates decreased with multiple recruitment opportunities and, at the population level, these rates also decreased over calendar time, independently of multiple recruitment opportunities. Using sequence analysis and hierarchical clustering, we identified three broad individual participation profiles: consenters (20%), switchers (43%) and refusers (37%). Men were over represented among refusers, women among consenters, and temporary non-residents among switchers. The specific subgroup of persons who were systemically not contacted or refusers constitutes a challenge for population-based surveillance and interventions. PMID:25875851

Estimating HIV incidence and detection rates from surveillance data.

PubMed

Posner, Stephanie J; Myers, Leann; Hassig, Susan E; Rice, Janet C; Kissinger, Patricia; Farley, Thomas A

2004-03-01

Markov models that incorporate HIV test information can increase precision in estimates of new infections and permit the estimation of detection rates. The purpose of this study was to assess the functioning of a Markov model for estimating new HIV infections and HIV detection rates in Louisiana using surveillance data. We expanded a discrete-time Markov model by accounting for the change in AIDS case definition made by the Centers for Disease Control and Prevention in 1993. The model was applied to quarterly HIV/AIDS surveillance data reported in Louisiana from 1981 to 1996 for various exposure and demographic subgroups. When modeling subgroups defined by exposure categories, we adjusted for the high proportion of missing exposure information among recent cases. We ascertained sensitivity to changes in various model assumptions. The model was able to produce results consistent with other sources of information in the state. Estimates of new infections indicated a transition of the HIV epidemic in Louisiana from (1) predominantly white men and men who have sex with men to (2) women, blacks, and high-risk heterosexuals. The model estimated that 61% of all HIV/AIDS cases were detected and reported by 1996, yet half of all HIV/non-AIDS cases were yet to be detected. Sensitivity analyses demonstrated that the model was robust to several uncertainties. In general, the methodology provided a useful and flexible alternative for estimating infection and detection trends using data from a U.S. surveillance program. Its use for estimating current infection will need further exploration to address assumptions related to newer treatments.

Surveillance of recent HIV infections among newly diagnosed HIV cases in Germany between 2008 and 2014.

PubMed

Hofmann, Alexandra; Hauser, Andrea; Zimmermann, Ruth; Santos-Hövener, Claudia; Bätzing-Feigenbaum, Jörg; Wildner, Stephan; Kücherer, Claudia; Bannert, Norbert; Hamouda, Osamah; Bremer, Viviane; Bartmeyer, Barbara

2017-07-11

The HIV surveillance system in Germany is based on mandatory, anonymous notification of newly diagnosed HIV cases by laboratories. Because the time between HIV infection and the diagnosis of HIV varies widely between persons, it is difficult to determine the number of cases of recent HIV infection among newly diagnosed cases of HIV. In Germany, the BED-capture-enzyme immunoassay (BED-CEIA) has been used to distinguish between recent and long-standing HIV infection. The aim of this analysis is to report the proportion of cases of recent HIV infection among newly diagnosed cases in Germany between 2008 and 2014 and to identify factors associated with recent infections. A sample of voluntary laboratories among all HIV diagnostic laboratories was recruited. Residual blood from HIV diagnostic tests was spotted on filter paper as dried serum or dried plasma spots and was sent along with the notification form of the HIV cases. The BED-CEIA test was performed. A case was defined as recent HIV infection with a BED-CEIA test result of less than 0.8 normalized optical density, with the exclusion of CDC stage C. The proportion of recent newly diagnosed HIV infections among different groups (such as transmission groups, gender or age groups) was calculated. We used logistic regression to identify factors associated with recent HIV infection and to identify subpopulations with high proportions of recent HIV infections. Approximately 10,257 newly diagnosed cases were tested for recency using the BED-CEIA. In total, 3084 (30.4%) of those were recently infected with HIV. The highest proportion of recent HIV infections was found among men who had sex with men (MSM) (35%) and persons between 18 and 25 years of age (43.0%). Logistic regression revealed that female German intravenous drug users with a recent HIV infection had a higher chance of being detected than German MSM (OR 2.27). Surveillance of recent HIV infection is a useful additional tool to monitor the HIV epidemic in

HIV Surveillance Among Pregnant Women Attending Antenatal Clinics: Evolution and Current Direction.

PubMed

Dee, Jacob; Garcia Calleja, Jesus M; Marsh, Kimberly; Zaidi, Irum; Murrill, Christopher; Swaminathan, Mahesh

2017-12-05

Since the late 1980s, human immunodeficiency virus (HIV) sentinel serosurveillance among pregnant women attending select antenatal clinics (ANCs) based on unlinked anonymous testing (UAT) has provided invaluable information for tracking HIV prevalence and trends and informing global and national HIV models in most countries with generalized HIV epidemics. However, increased coverage of HIV testing, prevention of mother-to-child transmission (PMTCT), and antiretroviral therapy has heightened ethical concerns about UAT. PMTCT programs now routinely collect demographic and HIV testing information from the same pregnant women as serosurveillance and therefore present an alternative to UAT-based ANC serosurveillance. This paper reports on the evolution and current direction of the global approach to HIV surveillance among pregnant women attending ANCs, including the transition away from traditional UAT-based serosurveillance and toward new guidance from the World Health Organization and the Joint United Nations Programme on HIV/AIDS on the implementation of surveillance among pregnant women attending ANCs based on routine PMTCT program data. ©Jacob Dee, Jesus M Garcia Calleja, Kimberly Marsh, Irum Zaidi, Christopher Murrill, Mahesh Swaminathan. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 05.12.2017.

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these

HIV Surveillance Among Pregnant Women Attending Antenatal Clinics: Evolution and Current Direction

PubMed Central

Garcia Calleja, Jesus M; Marsh, Kimberly; Zaidi, Irum; Murrill, Christopher; Swaminathan, Mahesh

2017-01-01

Since the late 1980s, human immunodeficiency virus (HIV) sentinel serosurveillance among pregnant women attending select antenatal clinics (ANCs) based on unlinked anonymous testing (UAT) has provided invaluable information for tracking HIV prevalence and trends and informing global and national HIV models in most countries with generalized HIV epidemics. However, increased coverage of HIV testing, prevention of mother-to-child transmission (PMTCT), and antiretroviral therapy has heightened ethical concerns about UAT. PMTCT programs now routinely collect demographic and HIV testing information from the same pregnant women as serosurveillance and therefore present an alternative to UAT-based ANC serosurveillance. This paper reports on the evolution and current direction of the global approach to HIV surveillance among pregnant women attending ANCs, including the transition away from traditional UAT-based serosurveillance and toward new guidance from the World Health Organization and the Joint United Nations Programme on HIV/AIDS on the implementation of surveillance among pregnant women attending ANCs based on routine PMTCT program data. PMID:29208587

Potential adjustment methodology for missing data and reporting delay in the HIV Surveillance System, European Union/European Economic Area, 2015.

PubMed

Rosinska, Magdalena; Pantazis, Nikos; Janiec, Janusz; Pharris, Anastasia; Amato-Gauci, Andrew J; Quinten, Chantal; Ecdc Hiv/Aids Surveillance Network

2018-06-01

Accurate case-based surveillance data remain the key data source for estimating HIV burden and monitoring prevention efforts in Europe. We carried out a literature review and exploratory analysis of surveillance data regarding two crucial issues affecting European surveillance for HIV: missing data and reporting delay. Initial screening showed substantial variability of these data issues, both in time and across countries. In terms of missing data, the CD4+ cell count is the most problematic variable because of the high proportion of missing values. In 20 of 31 countries of the European Union/European Economic Area (EU/EEA), CD4+ counts are systematically missing for all or some years. One of the key challenges related to reporting delays is that countries undertake specific one-off actions in effort to capture previously unreported cases, and that these cases are subsequently reported with excessive delays. Slightly different underlying assumptions and effectively different models may be required for individual countries to adjust for missing data and reporting delays. However, using a similar methodology is recommended to foster harmonisation and to improve the accuracy and usability of HIV surveillance data at national and EU/EEA levels.

Improving HIV Surveillance Data for Public Health Action in Washington, DC: A Novel Multiorganizational Data-Sharing Method

PubMed Central

Smart, JC

2016-01-01

Background The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing. Objective This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia. Methods A deterministic algorithm of approximately 1000 lines was developed, including a person-matching system with Enhanced HIV/AIDS Reporting System (eHARS) variables. Person matching was defined in categories (from strongest to weakest): exact, very high, high, medium high, medium, medium low, low, and very low. The algorithm was verified using conventional component testing methods, manual code inspection, and comprehensive output file examination. Results were validated by jurisdictions using internal review processes. Results Of 161,343 uploaded eHARS records from District of Columbia (N=49,326), Maryland (N=66,200), and Virginia (N=45,817), a total of 21,472 persons were matched across jurisdictions over various strengths in a matching process totaling 21 minutes and 58 seconds in the privacy device, leaving 139,871 uniquely identified with only one jurisdiction. No records matched as medium low or low. Over 80% of the matches were identified as either exact or very high matches. Three separate validation methods were conducted for this study, and they all found ≥90% accuracy between records matched by this novel method and traditional matching methods. Conclusions This study illustrated a novel data-sharing approach that may facilitate timelier and better

HIV/AIDS in Bangladesh: a national surveillance

PubMed Central

Islam, Manirul; Mitra, Amal K; Mian, Anwarul Huq; Vermund, Sten H

2009-01-01

Summary Nationwide surveillance of HIV/AIDS from 1989 through 1996 in Bangladesh included several risk groups such as professional blood donors, patients with sexually transmitted diseases (STDs), pregnant women at antenatal clinics, commercial sex workers (CSWs), patients with tuberculosis, long-distance truck drivers, sailors, and non-residents. The population was enrolled by convenience sampling after taking informed consent. Among 70,676 persons tested, 80 (1.13 per 1000) were HIV positive. The prevalence rate was steady until 1994, and then increased rapidly. The rate among male heterosexuals was significantly higher than that in females (3.40 per 1000 versus 0.29 per 1000; odds ratio (OR) 11.60; 95% confidence intervals (CI) 6.45 to 21.16; P<0.0001). Twelve per cent of patients with STDs had HIV. The HIV cases concentrated in 2 districts, Sylhet (25/72) and Chittagong (20/72), that border India and Myanmar (formerly Burma), respectively. Frequent movement of people of Bangladesh to India, Pakistan, Myanmar and Thailand, where HIV rates are higher, is one of the possible sources of spread of the cases. Bangladesh has the potential to avert epidemic spread of HIV at its early stage. PMID:10454184

Trends of HIV-1 Seroincidence Among HIV-1 Sentinel Surveillance Groups in Cambodia, 1999–2002

PubMed Central

Saphonn, Vonthanak; Parekh, Bharat S.; Dobbs, Trudy; Mean, ChiVun; Bun, Leng Hor; Ly, Sun Penh; Heng, Sopheab; Detels, Roger

2010-01-01

Summary This study reports trends in HIV-1 incidence in Cambodia among different target groups in the HIV-1 Sentinel Surveillance Program in 1999, 2000, and 2002, using the newly developed IgG capture BED-enzyme (HIV subtypes B, E and D) immunoassay (BED-CEIA). HIV-1-positive specimens (n = 3599) from 4 sentinel groups in the HIV-1 Sentinel Surveillance Program from 1999 to 2002—brothel-based commercial sex workers (CSWs), indirect commercial sex workers (IDSWs), police, and women attending antenatal clinics (ANCs)—were tested using the BED-CEIA. Annualized incidence rates were calculated for each group and each geographic region. Between 1999 and 2002, incidence rates declined among CSWs from 13.9% to 6.45%, among IDSWs from 5.92% to 2.87%, and among police from 1.58% to 0.26%. In the ANC group, the incidence remained stable, 0.64% in 1999, 1.11% in 2000, and 0.59% in 2002. However, there was an increasing trend among ANCs in rural areas, from 0.12 to 0.89%. In conclusion, HIV-1 incidence among CSWs, IDSWs, and police has declined between 1999 and 2002; however, the incidence has not declined in the ANC group. PMID:16044012

[HIV and syphilis coinfection in pregnancy and vertical HIV transmission: a study based on epidemiological surveillance data].

PubMed

Acosta, Lisiane M W; Gonçalves, Tonantzin Ribeiro; Barcellos, Nêmora Tregnago

2016-12-01

To estimate the rate of HIV and syphilis coinfection among pregnant women living in Porto Alegre, Brazil, as well as the association of coinfection with vertical HIV transmission and socioeconomic variables. This analytical retrospective cross-sectional study employed data from the regular epidemiological surveillance system for the period from 2010 to 2013. Data were obtained regarding pregnant women with HIV and exposed children, syphilis in pregnancy, and congenital syphilis. The study population included 1 500 HIV-positive women with deliveries from 2010 to 2013. Of these, 155 (10.3%) were also infected with syphilis, corresponding to an HIV and syphilis coinfection rate of 10.2% (± 1.5%). The coinfected group had lower education levels, higher prevalence of black women, and greater HIV exposure related to drug use by the woman or a partner. Coinfected women had more delayed HIV diagnosis (for example, during childbirth) and greater prevalence of lacking prenatal care (44%). Crude analysis showed an association between vertical HIV transmission and HIV and syphilis co-infection (PR = 2.1; 95%CI: 1.21-3.74; P = 0.01) that persisted in the adjusted analysis. A profile of increased vulnerability was identified among pregnant women with HIV and syphilis coinfection. A positive impact of the treatment to reduce congenital syphilis and eliminate vertical transmission of HIV depends on enhanced access to qualified health care.

Completeness of hepatitis, brucellosis, syphilis, measles and HIV/AIDS surveillance in Izmir, Turkey.

PubMed

Durusoy, Raika; Karababa, Ali O

2010-02-17

According to the surveillance system in Turkey, most diseases are notified only by clinicians, without involving laboratory notification. It is assumed that a considerable inadequacy in notifications exists; however, this has not been quantified by any researcher. Our aim was to evaluate the completeness of communicable disease surveillance in the province of Izmir, Turkey for the year of 2003 by means of estimating the incidences of diseases. Data on positive laboratory results for the notifiable and serologically detectable diseases hepatitis A, B, C, brucellosis, syphilis, measles and HIV detected in 2003 in Izmir (population 3.5 million) were collected from serology laboratories according to WHO surveillance standards and compared to the notifications received by the Provincial Health Directorate. Data were checked for duplicates and matched. Incidences were estimated with the capture-recapture method. Sensitivities of both notifications and laboratory data were calculated according to these estimates. Among laboratories performing serologic tests (n = 158) in Izmir, 84.2% accepted to participate, from which 23,515 positive results were collected. Following the elimination of duplicate results as well as of cases residing outside of Izmir, the total number was 11,402. The total number of notifications was 1802. Notification rates of cases found in laboratories were 31.6% for hepatitis A, 12.1% for acute hepatitis B, 31.8% for brucellosis, 25.9% for syphilis and 100% for HIV confirmation. It was discovered that for hepatitis A, B, C, brucellosis and syphilis, there is a considerable under-notification by clinicians and that laboratory data has the potential of contributing greatly to their surveillance. The inclusion of laboratories in the surveillance system of these diseases could help to achieve completeness of reporting.

Acceptance of the Use of HIV Surveillance Data for Care Engagement: National and Local Community Perspectives

PubMed Central

Evans, David; Van Gorder, Dana; Morin, Stephen F.; Steward, Wayne T.; Gaffney, Stuart; Charlebois, Edwin D.

2015-01-01

Background Use of surveillance data including laboratory results (e.g. CD4 and HIV RNA) by public health departments to facilitate linkage, retention, and re-engagement of HIV-infected individuals in health care is on the rise. This is part of the goal of increasing the proportion of infected persons achieving virologic suppression. However, this use of surveillance data is not without controversy, particularly among some providers and people living with HIV. Methods We conducted informal discussions with key stakeholders and a literature search, and held a national think tank in November 2012, bringing together 31 representatives of the federal government, county and state officials, health care providers, and community-based organizations. A follow-up community consultation specific to San Francisco was held January 24, 2014, with 10 participants. Notes from these activities were used as data for this analysis. Results The think tank identified three strategies utilizing HIV surveillance data to aid in care engagement: 1) provider-mediated – where health department staff work with the provider of record on re-engagement, 2) electronic linkages between surveillance databases and medical records databases, and 3) direct outreach – where trained health department staff reach out to persons out of care. Participants also developed recommendations for minimizing harm, guidance on meaningful stakeholder involvement, and a consensus statement in support of the use of HIV surveillance data in care engagement. Conclusions Acceptance of the use of surveillance data for HIV care linkage, retention, and re-engagement is achievable, particularly if stakeholders have been engaged in the design, conduct, and evaluation of programs. PMID:25867776

It's Never Just HIV: Exposure to an HIV Prevention Media Campaign and Behavior Change Among Men Who Have Sex with Men Participating in the National HIV Behavioral Surveillance System in New York City.

PubMed

Reilly, Kathleen H; Neaigus, Alan; Shepard, Colin W; Cutler, Blayne H; Sweeney, Monica M; Rucinski, Katherine B; Jenness, Samuel M; Wendel, Travis; Marshall, David M; Hagan, Holly

2016-08-01

The aim of this study was to assess the exposure to and impact of the It's Never Just HIV mass media campaign aimed at HIV negative men who have sex with men (MSM) in New York City. Questions about the campaign were included in the local questionnaire of the Centers for Disease Control and Prevention (CDC)-sponsored National HIV Behavioral Surveillance (NHBS) study of MSM in NYC conducted in 2011. Participants in this cross-sectional study were recruited using venue-based sampling. Among 447 NYC National HIV Behavioral Surveillance study participants who self-reported HIV negative or unknown status and answered questions about the NYC Department of Health and Mental Hygiene's It's Never Just HIV campaign, more than one-third (n = 173, 38.7%) reported having seen the campaign. Latinos (34.8%) and blacks (34.4%) were less likely to report seeing the campaign compared to whites (47.7%). Most of those who reported seeing the campaign saw it on the subway (80.1%). Only 9.4% of those who saw the campaign reported having changed their sexual or health behaviors in response to the campaign. These data suggest that thousands of HIV-uninfected MSM in NYC have been reached by the campaign and recalled its message.

Use of Surveillance Data on HIV Diagnoses with HIV-Related Symptoms to Estimate the Number of People Living with Undiagnosed HIV in Need of Antiretroviral Therapy

PubMed Central

van Sighem, Ard; Sabin, Caroline A.; Phillips, Andrew N.

2015-01-01

Background It is important to have methods available to estimate the number of people who have undiagnosed HIV and are in need of antiretroviral therapy (ART). Methods The method uses the concept that a predictable level of occurrence of AIDS or other HIV-related clinical symptoms which lead to presentation for care, and hence diagnosis of HIV, arises in undiagnosed people with a given CD4 count. The method requires surveillance data on numbers of new HIV diagnoses with HIV-related symptoms, and the CD4 count at diagnosis. The CD4 count-specific rate at which HIV-related symptoms develop are estimated from cohort data. 95% confidence intervals can be constructed using a simple simulation method. Results For example, if there were 13 HIV diagnoses with HIV-related symptoms made in one year with CD4 count at diagnosis between 150–199 cells/mm3, then since the CD4 count-specific rate of HIV-related symptoms is estimated as 0.216 per person-year, the estimated number of person years lived in people with undiagnosed HIV with CD4 count 150–199 cells/mm3 is 13/0.216 = 60 (95% confidence interval: 29–100), which is considered an estimate of the number of people living with undiagnosed HIV in this CD4 count stratum. Conclusions The method is straightforward to implement within a short period once a surveillance system of all new HIV diagnoses, collecting data on HIV-related symptoms at diagnosis, is in place and is most suitable for estimating the number of undiagnosed people with CD4 count <200 cells/mm3 due to the low rate of developing HIV-related symptoms at higher CD4 counts. A potential source of bias is under-diagnosis and under-reporting of diagnoses with HIV-related symptoms. Although this method has limitations as with all approaches, it is important for prompting increased efforts to identify undiagnosed people, particularly those with low CD4 count, and for informing levels of unmet need for ART. PMID:25768925

Use of surveillance data on HIV diagnoses with HIV-related symptoms to estimate the number of people living with undiagnosed HIV in need of antiretroviral therapy.

PubMed

Lodwick, Rebecca K; Nakagawa, Fumiyo; van Sighem, Ard; Sabin, Caroline A; Phillips, Andrew N

2015-01-01

It is important to have methods available to estimate the number of people who have undiagnosed HIV and are in need of antiretroviral therapy (ART). The method uses the concept that a predictable level of occurrence of AIDS or other HIV-related clinical symptoms which lead to presentation for care, and hence diagnosis of HIV, arises in undiagnosed people with a given CD4 count. The method requires surveillance data on numbers of new HIV diagnoses with HIV-related symptoms, and the CD4 count at diagnosis. The CD4 count-specific rate at which HIV-related symptoms develop are estimated from cohort data. 95% confidence intervals can be constructed using a simple simulation method. For example, if there were 13 HIV diagnoses with HIV-related symptoms made in one year with CD4 count at diagnosis between 150-199 cells/mm3, then since the CD4 count-specific rate of HIV-related symptoms is estimated as 0.216 per person-year, the estimated number of person years lived in people with undiagnosed HIV with CD4 count 150-199 cells/mm3 is 13/0.216 = 60 (95% confidence interval: 29-100), which is considered an estimate of the number of people living with undiagnosed HIV in this CD4 count stratum. The method is straightforward to implement within a short period once a surveillance system of all new HIV diagnoses, collecting data on HIV-related symptoms at diagnosis, is in place and is most suitable for estimating the number of undiagnosed people with CD4 count <200 cells/mm3 due to the low rate of developing HIV-related symptoms at higher CD4 counts. A potential source of bias is under-diagnosis and under-reporting of diagnoses with HIV-related symptoms. Although this method has limitations as with all approaches, it is important for prompting increased efforts to identify undiagnosed people, particularly those with low CD4 count, and for informing levels of unmet need for ART.

Review of sampling hard-to-reach and hidden populations for HIV surveillance.

PubMed

Magnani, Robert; Sabin, Keith; Saidel, Tobi; Heckathorn, Douglas

2005-05-01

Adequate surveillance of hard-to-reach and 'hidden' subpopulations is crucial to containing the HIV epidemic in low prevalence settings and in slowing the rate of transmission in high prevalence settings. For a variety of reasons, however, conventional facility and survey-based surveillance data collection strategies are ineffective for a number of key subpopulations, particularly those whose behaviors are illegal or illicit. This paper critically reviews alternative sampling strategies for undertaking behavioral or biological surveillance surveys of such groups. Non-probability sampling approaches such as facility-based sentinel surveillance and snowball sampling are the simplest to carry out, but are subject to a high risk of sampling/selection bias. Most of the probability sampling methods considered are limited in that they are adequate only under certain circumstances and for some groups. One relatively new method, respondent-driven sampling, an adaptation of chain-referral sampling, appears to be the most promising for general applications. However, as its applicability to HIV surveillance in resource-poor settings has yet to be established, further field trials are needed before a firm conclusion can be reached.

Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance

PubMed Central

McGovern, Mark E.; Marra, Giampiero; Radice, Rosalba; Canning, David; Newell, Marie-Louise; Bärnighausen, Till

2015-01-01

participated in testing, and 18% estimated with imputation. We provide new confidence intervals that correct for the fact that the relationship between testing and HIV status is unknown and requires estimation. Conclusions We confirm the feasibility and value of adopting selection models to account for missing data in population-based HIV surveys and surveillance systems. Elements of survey design, such as interviewer identity, present the opportunity to adopt this approach in routine applications. Where non-participation is high, true confidence intervals are much wider than those generated by standard approaches to dealing with missing data suggest. PMID:26613900

Shifting Patterns of the HIV Epidemic in Southwest China: A Case Study Based on Sentinel Surveillance, 1995-2012.

PubMed

Chow, Eric P F; Gao, Liangmin; Chen, Liang; Jing, Jun; Zhang, Lei

2015-06-01

The HIV epidemic is experiencing a rapid shift in transmission profile in China. This study aims to examine the changes in magnitude, transmission pattern, and trend of the HIV epidemic in a typical Southwest Chinese prefecture over the period of 1995-2012. HIV surveillance data from the web-based reporting system were analyzed during this period. We investigated the temporal trends in the changing characteristics of HIV transmission, the HIV disease burden in key affected populations, and assessed the impacts on HIV disease progression due to scale-up of antiretroviral treatment. A total of 3556 HIV/AIDS cases were reported in Yuxi prefecture, Yunnan, over the study period. The number of HIV tests conducted has dramatically increased from 1041 in 1995 to 247,859 in 2012, resulting in a substantial increase in HIV diagnoses from 11 cases to 327 cases over the same period. Since 2005, cumulatively 1250 eligible people living with HIV (PLHIV) have received combination antiretroviral therapy which reduced AIDS disease progression from 9.0% (95% CI: 6.7-11.4%) in 1995 to 0.1% (0-0.3%) in 2012 (ptrend=0.0002). The primary mode of HIV transmission has been shifted from injection sharing (71.9% diagnoses in 1995-2004) to unsafe sexual contacts (82.6% diagnoses in 2012). Yuxi prefecture is experiencing a concentrated but shifting HIV epidemic. Scale-up of HIV testing is essential to effective sentinel surveillance and enhancing early diagnosis and treatment in PLHIV.

Estimating the Return of Persons Living With HIV/AIDS to New Orleans: Methods for Conducting Disease Surveillance in the Wake of a Natural Disaster

PubMed Central

Robinson, William T.; Wendell, Debbie; Gruber, DeAnn; Foxhood, Joseph; Scalco, M. Beth; Zapata, Amy

2008-01-01

Hurricane Katrina disrupted HIV/AIDS surveillance by invalidating the New Orleans, La, surveillance and population data on persons living with HIV/AIDS. We describes 2 methods—population return and HIV surveillance data—to estimate the return of the infected population to New Orleans. It is estimated that 58% to 64% of 7068 persons living with HIV/AIDS returned by summer 2006. Although developed for HIV planning, these methods could be used with other disease surveillance programs. PMID:18309138

Recent HIV Testing Prevalence, Determinants, and Disparities Among US Older Adult Respondents to the Behavioral Risk Factor Surveillance System

PubMed Central

Ford, Chandra L.; Godette, Dionne C.; Mulatu, Mesfin S.; Gaines, Tommi L.

2016-01-01

Background Although routine human immune deficiency virus (HIV) testing during health care visits is recommended for most adults, many older adults (i.e., ages 50–64 years) do not receive it. This study identified factors associated with HIV testing in the past 12 months (i.e., recent HIV testing) among US adults in the 3 categories of older adulthood (50–54, 55–59, and 60–64 years) for which routine HIV testing is recommended. Method This was a cross-sectional analysis of data from US older adult respondents to the 2010 Behavioral Risk Factor Surveillance System. We calculated prevalence (proportions) of HIV testing by age category and race/ethnicity. Using multiple logistic regression, we identified predisposing, enabling, and need factors associated with recent HIV testing within and across age categories, by race/ethnicity and controlling for covariates. Results HIV testing prevalence was low (<5%), varied by race/ethnicity, and decreased with age. Within and across age categories, the odds of testing were highest among blacks (odds ratio [OR], 3.47; 95% confidence interval [CI], 2.82–4.25) and higher among Latinos (OR, 2.06; 95% CI, 1.50–2.84) and the oldest and youngest categories of American Indians/Alaska Natives (OR, 2.48; 95% CI, 1.11–5.55; OR, 2.98; 95% CI, 1.49–5.95) than among whites. Those reporting a recent doctor visit (OR, 2.32; 95% CI, 1.92–2.74) or HIV risk behaviors (OR, 3.50; 95% CI, 2.67–4.59) had higher odds of HIV testing. Conclusion Regardless of risk, the oldest older adults, whites, and older women may forego HIV testing. Doctor visits may facilitate HIV testing. Additional research is needed to understand why eligible older adults seen by providers may not be screened for HIV infection. PMID:26165428

[Survey adaptation for bio-behavioural surveillance of HIV in Chilean female sex workers].

PubMed

Carvajal, Bielka; Stuardo, Valeria; Manríquez, José Manuel; Belmar, Julieta; Folch, Cinta

To adapt a behavioural questionnaire for second-generation HIV/AIDS surveillance in female sex workers (FSWs) in the Metropolitan Region, Chile. Qualitative study of instruments validation. A Spanish instrument adapted in Catalonia was validated through a translation and back-translation of the original version. The content validity was determined through a modified Delphi method, via FSW and HIV experts representing community, political and institutional levels. Applicability aspects were determined by the application of the questionnaire to FSW in the Metropolitan Region. The questionnaire, drafted in Spain, was successfully adapted to Chilean Spanish. The content validity process enabled sections to be created that address HIV in FSWs. The adapted questionnaire takes less than 15minutes to complete, which makes it usable in fieldwork. The 61 women surveyed came from different countries (all were Latin Americans) and had different educational levels; all this enabled potential applicability problems to be detected. The adapted questionnaire for Chile contains all the UNAIDS indicators for FSWs, as well as the recommended indicators of Family Health International for bio-behavioural surveillance. Said questionnaire serves as a tool for second-generation HIV/other STD surveillance and further contributes to preventive policies in Chilean FSWs. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Use of Sentinel Surveillance and Geographic Information Systems to Monitor Trends in HIV Prevalence, Incidence, and Related Risk Behavior among Women Undergoing Syphilis Screening in a Jail Setting

PubMed Central

Kim, Andrea A.; Klausner, Jeffrey D.; Goldenson, Joe; Kent, Charlotte; Liska, Sally; McFarland, Willi

2008-01-01

Innovative methods are needed to systematically track the HIV epidemic and appropriately target prevention and care programs in vulnerable populations of women. We conducted sentinel surveillance among women entering the jail system of San Francisco from 1999 to 2001 to track trends in HIV incidence, HIV prevalence, and related risk behavior. Using geographic information software (GIS), we triangulated findings to examine the spatial distribution of risk and disease. A total of 1,577 female arrestees voluntarily screened for sexually transmitted diseases at intake were included. HIV incidence, estimated using the serologic testing algorithm for recent HIV seroconversion (STARHS), was 0.4% per year (95% confidence interval [95%CI] = 0.1–2.1). HIV prevalence was 1.8% (95%CI = 1.1–2.4). HIV infection was independently associated with age 30 to 39 years compared to all other ages, African-American race/ethnicity vs. non-African-American, and recent injection drug use. Maps showed that the communities in which arrested women reside are also those with the highest concentrations of newly detected female HIV cases, AIDS cases, and clients of substance use programs. The combined strategy of using sentinel surveillance in the jail setting and GIS to map the spatial distribution of disease provides a useful tool to identify patterns of risk in hard-to-reach, vulnerable populations of women. PMID:18785013

Health & demographic surveillance system profile: The Kombewa health and demographic surveillance system (Kombewa HDSS).

PubMed

Sifuna, Peter; Oyugi, Mary; Ogutu, Bernhards; Andagalu, Ben; Otieno, Allan; Owira, Victorine; Otsyula, Nekoye; Oyieko, Janet; Cowden, Jessica; Otieno, Lucas; Otieno, Walter

2014-08-01

The Kombewa Health and Demographic Surveillance System (HDSS) grew out of the Kombewa Clinical Research Centre in 2007 and has since established itself as a platform for the conduct of regulated clinical trials, nested studies and local disease surveillance. The HDSS is located in a rural part of Kisumu County, Western Kenya, and covers an area of about 369 km(2) along the north-eastern shores of Lake Victoria. A dynamic cohort of 141 956 individuals drawn from 34 718 households forms the HDSS surveillance population. Following a baseline survey in 2011, the HDSS continues to monitor key population changes through routine biannual household surveys. The intervening period between set-up and baseline census was used for preparatory work, in particular Global Positioning System (GPS) mapping. Routine surveys capture information on individual and households including residency, household relationships, births, deaths, migrations (in and out) and causes of morbidity (syndromic incidence and prevalence) as well as causes of death (verbal autopsy). The Kombewa HDSS platform is used to support health research activities, that is clinical trials and epidemiological studies evaluating diseases of public health importance including malaria, HIV and global emerging infectious diseases such as dengue fever. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

HIV-Prevalence in Tuberculosis Patients in Germany, 2002–2009: An Estimation Based on HIV and Tuberculosis Surveillance Data

PubMed Central

Fiebig, Lena; Kollan, Christian; Hauer, Barbara; Gunsenheimer-Bartmeyer, Barbara; an der Heiden, Matthias; Hamouda, Osamah; Haas, Walter

2012-01-01

Tuberculosis (TB) and HIV comorbidity is a major challenge in TB prevention and control but difficult to assess in Germany as in other countries, where data confidentiality precludes notifying the HIV status of TB patients. We aimed to estimate the HIV-prevalence in TB patients in Germany, 2002–2009, and to characterize the HIV/TB patients demographically. Data from the long-term observational open multicentre cohort ClinSurv HIV were used to identify incident TB in HIV-positive individuals. We assessed the cohort’s coverage for the nationwide HIV-positive population by contrasting ClinSurv HIV patients under antiretroviral therapy (ART) with national HIV patient numbers derived from ART prescriptions (data by Insight Health; available for 2006–2009). The HIV-prevalence in TB patients was calculated as the number of HIV/TB cases projected for Germany over all culture-positive TB notifications. From 2002 to 2009, 298 of 15,531 HIV-positive patients enrolled in the ClinSurv HIV cohort were diagnosed with TB. A 21% cohort coverage was determined. The annual estimates of the HIV-prevalence in TB patients were on average 4.5% and ranged from 3.5% (95%CI 2.3–5.1%) in 2007 to 6.6% (95%CI 5.0–8.5%) in 2005. The most recent estimate for 2009 was 4.0% (95%CI 2.6–5.9%). The 298 HIV/TB patients were characterized by a male-to-female ratio of 2.1, by a median age of 38 years at TB diagnosis, and by 59% of the patients having a foreign origin, mainly from Subsahara Africa. We provide, to our knowledge, the first estimate of the HIV-prevalence in TB patients for Germany by joint evaluation of anonymous HIV and TB surveillance data sources. The identified level of HIV in TB patients approximates available surveillance data from neighbouring countries and indicates a non-negligible HIV/TB burden in Germany. Our estimation approach is valuable for epidemiological monitoring of HIV/TB within the current legal frameworks. PMID:23145087

Integration of Surveillance for STDs, HIV, Hepatitis, and TB: A Survey of U.S. STD Control Programs.

PubMed

Dowell, Deborah; Gaffga, Nicholas H; Weinstock, Hillard; Peterman, Thomas A

2009-01-01

Integration of surveillance for sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), hepatitis, and tuberculosis (TB) may improve disease prevention and control. We determined the extent of surveillance integration in these programs, the benefits of integration, and barriers to increased integration. We e-mailed a survey to the 58 federally funded local and state STD control programs and followed up with phone interviews of nine program representatives. The response rate was 81%. Many had compared infections by population subgroup for STDs and HIV (89%), STDs and hepatitis (53%), or STDs and TB (28%). Most (74%) had examined co-infections with HIV and STDs at the individual level and entered STD and HIV surveillance data into the same database (54%). All respondents thought some integration would be useful. Many (72%) used integrated data to disseminate information or change program strategies. The most commonly reported barriers to integration were policies preventing work with HIV data (85%) and incompatible databases (59%). Most STD control programs in the United States have some experience integrating surveillance data, but the degree of integration varies widely. Specific barriers to further integration were identified. The Centers for Disease Control and Prevention can help address these barriers by facilitating access to information and sharing technical solutions. Local and state programs can continue advancing surveillance integration by improving understanding of where integrated data are needed, increasing the use of available data, and pressing for appropriate and secure data sharing.

Feasibility Study of HIV Sentinel Surveillance using PMTCT data in Cameroon: from Scientific Success to Programmatic Failure.

PubMed

Billong, Serge C; Dee, Jacob; Fokam, Joseph; Nguefack-Tsague, Georges; Ekali, Gabriel L; Fodjo, Raoul; Temgoua, Edith S; Billong, Edson-Joan; Sosso, Samuel M; Mosoko, Jembia J; Monebenimp, Francisca; Ndjolo, Alexis; Bissek, Anne-Cecile Z-K; Bolu, Omotayo; Elat, Jean-Bosco N

2017-01-03

In low-income countries (LICs), HIV sentinel surveillance surveys (HIV-SSS) are recommended in between two demographic and health surveys, due to low-cost than the latter. Using the classical unlinked anonymous testing (UAT), HIV-SSS among pregnant women raised certain ethical and financial challenges. We therefore aimed at evaluating how to use prevention of mother-to-child transmission of HIV (PMTCT) routine data as an alternative approach for HIV-SSS in LICs. A survey conducted through 2012 among first antenatal-care attendees (ANC1) in the ten regions of Cameroon. HIV testing was performed at PMTCT clinics as-per the national serial algorithm (rapid test), and PMTCT site laboratory (PMTCT-SL) performances were evaluated by comparison with results of the national reference laboratory (NRL), determined as the reference standard. Acceptance rate for HIV testing was 99%, for a total of 6521 ANC1 (49 · 3% aged 15-24) enrolled nationwide. Among 6103 eligible ANC1, sensitivity (using NRL testing as the reference standard) was 81 · 2%, ranging from 58 · 8% (South region) to 100% (West region); thus implying that 18 · 8% HIV-infected ANC1 declared HIV-negative at the PMTCT-SL were positive from NRL-results. Specificity was 99 · 3%, without significant disparity across sites. At population-level, this implies that every year in Cameroon, ~2,500 HIV-infected women are wrongly declared seronegative, while ~1,000 are wrongly declared seropositive. Only 44 · 4% (16/36) of evaluated laboratories reached the quality target of 80%. The study identified weaknesses in routine PMTCT HIV testing. As Cameroon transitions to using routine PMTCT data for HIV-SSS among pregnant women, there is need in optimizing quality system to ensure robust routine HIV testing for programmatic and surveillance purposes.

HIV epidemic and human rights among men who have sex with men in sub-Saharan Africa: Implications for HIV prevention, care, and surveillance.

PubMed

Abara, Winston E; Garba, Ibrahim

2017-04-01

Recent research has presented evidence that men who have sex with men (MSM) bear a disproportionate burden of HIV and are at increased risk for HIV in sub-Saharan Africa (SSA). However, many countries in SSA have failed to address the needs of MSM in national HIV/AIDS programmes. Furthermore, many MSM face structural barriers to HIV prevention and care, the most significant of which include laws that criminalise male-to-male sexual contact and facilitate stigma and discrimination. This in turn increases the vulnerability of MSM to acquiring HIV and presents barriers to HIV prevention, care, and surveillance. This relationship illustrates the link between human rights, social justice, and health outcomes and presents considerable challenges to addressing the HIV epidemic among MSM in SSA. The response to the HIV epidemic in SSA requires a non-discriminatory human rights approach to all at-risk groups, including MSM. Existing international human rights treaties, to which many SSA countries are signatories, and a 'health in all policies' approach provides a strong basis to reduce structural barriers to HIV prevention, care, surveillance, and research, and to ensure that all populations in SSA, including MSM, have access to the full range of rights that help ensure equal opportunities for health and wellness.

Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators.

PubMed

Barcellos, Christovam; Acosta, Lisiane Morelia Weide; Lisboa, Eugenio; Bastos, Francisco Inácio

2009-12-01

To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition. Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test. There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services. Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.

Epidemiology of the Viral Hepatitis-HIV Syndemic in San Francisco: A Collaborative Surveillance Approach

PubMed Central

Scheer, Susan; Shallow, Sue; Pipkin, Sharon; Huang, Sandra

2014-01-01

Objectives To describe the epidemiology of people coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV in San Francisco, the San Francisco Department of Public Health's Communicable Disease Control and Prevention Section and the HIV Epidemiology Section collaborated to link their registries. Methods In San Francisco, hepatitis reporting is primarily through passive laboratory-based surveillance, and HIV/AIDS reporting is primarily through laboratory-initiated active surveillance. We conducted the registry linkage in 2010 using a sequential algorithm. Results The registry match included 31,997 HBV-infected people who were reported starting in 1984; 10,121 HCV-infected people who were reported starting in 2001; and 34,551 HIV/AIDS cases reported beginning in 1981. Of the HBV and HCV cases, 6.3% and 12.6% were coinfected with HIV, respectively. The majority of cases were white males; however, black people were disproportionately affected. For more than 90% of the HBV/HIV cases, male-to-male sexual contact (men who have sex with men [MSM]) was the risk factor for HIV infection. Injection drug use was the most frequent risk factor for HIV infection among the HCV/HIV cases; however, 35.6% of the HCV/HIV coinfected males were MSM but not injection drug users. Conclusions By linking the two registries, we found new ways to foster collaborative work and expand our programmatic flexibility. This analysis identified particular populations at risk for coinfection, which can be used by viral hepatitis and HIV screening, prevention, and treatment programs to integrate, enhance, target, and prioritize prevention services and clinical care within the community to maximize health outcomes. PMID:24385655

Surveillance of transmitted HIV drug resistance in antiretroviral-naive patients aged less than 25 years, in Bangkok, Thailand.

PubMed

Sungkanuparph, Somnuek; Pasomsub, Ekawat; Chantratita, Wasun

2014-01-01

Emergence of transmitted HIV drug resistance (TDR) is a concern after global scale-up of antiretroviral therapy (ART). World Health Organization had developed threshold survey method for surveillance of TDR in resource-limited countries. ART in Thailand has been scaling up for >10 years. To evaluate the current TDR in Thailand, a cross-sectional study was conducted among antiretroviral-naive HIV-infected patients aged <25 years who newly visited infectious disease clinic in a university hospital, in 2011. HIV genotypic-resistance test was performed. World Health Organization 2009 surveillance drug-resistance mutations were used to define TDR. Of 50 patients, the prevalence of TDR was 4%. Of 2 patients with TDR, 1 had K103N and the other had Y181C mutations. Transmitted HIV drug resistance is emerging in Thailand after a decade of rapid scale-up of ART. Interventions to prevent TDR at the population level are essentially needed in Thailand. Surveillance for TDR in Thailand has to be regularly performed.

Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study

PubMed Central

Hullur, Nitya; D’Ambruoso, Lucia; Edin, Kerstin; Wagner, Ryan G; Ngobeni, Sizzy; Kahn, Kathleen; Tollman, Stephen; Byass, Peter

2016-01-01

Background South Africa faces a complex burden of disease consisting of infectious and non–communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. The study objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north–east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality. Methods Drawing on community–based participatory research (CBPR) methods, three village–based groups of eight participants were convened, with whom a series of discussions were held to identify and define the causes of, treatments for, and problems surrounding, deaths due to HIV/AIDS and violent assault. The surveillance system was also discussed and recommendations generated. The discussion narratives were the main data source, examined using framework analysis. Results The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. Views on health surveillance were positive. Recommendations to strengthen an already well–functioning system related to maintaining confidentiality and sensitivity, and extending ancillary care obligations. Conclusion The discussions provided information not available from other sources on

Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year.

PubMed

Karch, Debra L; Chen, Mi; Tang, Tian

2014-01-01

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

Factors associated with repeated refusal to participate in longitudinal population-based HIV surveillance in rural South Africa: an observational study, regression analyses

PubMed Central

Giordano, Katie; McGrath, Nuala; Snow, Rachel; Harlow, Siobán; Newell, Marie-Louise

2014-01-01

Background For many estimation purposes, individuals who repeatedly refuse to participate in longitudinal HIV surveillance pose a bigger threat to valid inferences than individuals who participate at least occasionally. We investigate the determinants of repeated refusal to consent to HIV testing in a population-based longitudinal surveillance in rural South Africa. Methods We used data from two years (2005 & 2006) of the annual HIV surveillance conducted by the Africa Centre for Health and Population Studies, linking the HIV surveillance data to demographic and socioeconomic data. The outcome for the analysis was “repeated refusal”. Demographic variables included sex, age, highest educational attainment, and place of residence. We also included a measure of wealth and the variable “ever had sex”. To compare the association of each variable with the outcome, unadjusted odds ratios and standard errors were estimated. Multivariable logistic regression was used to estimate adjusted odds ratios and their standard errors. Data were analyzed using STATA 10.0. Results Of 15,557 eligible individuals, 46% refused to test for HIV in both rounds. Males were significantly more likely than females to repeatedly refuse testing. Holding all other variables constant, individuals in the middle age groups were more likely to repeatedly refuse testing compared with younger and older age groups. The odds of repeated refusal increased with increasing level of education and relative wealth. People living in urban areas were significantly more likely to repeatedly refuse an HIV test than people living in peri-urban or rural areas. Compared to those who had ever had sex, both males and females who had not yet had sex were significantly more likely to refuse to participate. Conclusions The likelihood of repeated refusal to test for HIV in this longitudinal surveillance increases with education, wealth, urbanization, and primary sexual abstinence. Since the factors determining

Using HIV Surveillance Registry Data to Re-Link Persons to Care: The RSVP Project in San Francisco

PubMed Central

Buchacz, Kate; Chen, Miao-Jung; Parisi, Maree Kay; Yoshida-Cervantes, Maya; Antunez, Erin; Delgado, Viva; Moss, Nicholas J.; Scheer, Susan

2015-01-01

Background Persons with unsuppressed HIV viral load (VL) who disengage from care may experience poor clinical outcomes and potentially transmit HIV. We assessed the feasibility and yield of using the San Francisco Department of Public Health (SFDPH) enhanced HIV surveillance system (eHARS) to identify and re-engage such persons in care. Methods Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for “out-of-care”) and a VL >200 copies/mL drawn nine to 15 months earlier. We prioritized cases residing locally for investigation, and used information from eHARS and medical and public health databases to contact them for interview and referral to the SFDPH linkage services (LINCS). Twelve months later, we matched-back to eHARS data to assess how HIV laboratory reporting delays affected original eligibility, and if persons had any HIV laboratory results performed and reported within 12 months after index date (‘new labs’). Results Among 434 eligible persons, 282 were prioritized for investigation, of whom 75 (27%) were interviewed, 79 (28%) could not be located, and 48 (17%) were located out of the area. Among the interviewed, 54 (72%) persons accepted referral to LINCS. Upon match-back to eHARS data, 324 (75%) in total were confirmed as eligible, including 221 (78%) of the investigated; most had new labs. Conclusions Among the investigated persons presumed out-of-care, we interviewed and offered LINCS referral to about one-quarter, demonstrating the feasibility but limited yield of our project. Matching to updated surveillance data revealed that a substantial minority did not disengage from care and that most re-engaged in HIV care. Verifying persons’ HIV care status with medical providers and improving timeliness of transfer and cross-jurisdictional sharing of HIV laboratory data may aid future efforts. PMID:25748668

Low-Cost Ultra-Wide Genotyping Using Roche/454 Pyrosequencing for Surveillance of HIV Drug Resistance

PubMed Central

Dudley, Dawn M.; Chin, Emily N.; Bimber, Benjamin N.; Sanabani, Sabri S.; Tarosso, Leandro F.; Costa, Priscilla R.; Sauer, Mariana M.; Kallas, Esper G.; O.’Connor, David H.

2012-01-01

Background Great efforts have been made to increase accessibility of HIV antiretroviral therapy (ART) in low and middle-income countries. The threat of wide-scale emergence of drug resistance could severely hamper ART scale-up efforts. Population-based surveillance of transmitted HIV drug resistance ensures the use of appropriate first-line regimens to maximize efficacy of ART programs where drug options are limited. However, traditional HIV genotyping is extremely expensive, providing a cost barrier to wide-scale and frequent HIV drug resistance surveillance. Methods/Results We have developed a low-cost laboratory-scale next-generation sequencing-based genotyping method to monitor drug resistance. We designed primers specifically to amplify protease and reverse transcriptase from Brazilian HIV subtypes and developed a multiplexing scheme using multiplex identifier tags to minimize cost while providing more robust data than traditional genotyping techniques. Using this approach, we characterized drug resistance from plasma in 81 HIV infected individuals collected in São Paulo, Brazil. We describe the complexities of analyzing next-generation sequencing data and present a simplified open-source workflow to analyze drug resistance data. From this data, we identified drug resistance mutations in 20% of treatment naïve individuals in our cohort, which is similar to frequencies identified using traditional genotyping in Brazilian patient samples. Conclusion The developed ultra-wide sequencing approach described here allows multiplexing of at least 48 patient samples per sequencing run, 4 times more than the current genotyping method. This method is also 4-fold more sensitive (5% minimal detection frequency vs. 20%) at a cost 3–5× less than the traditional Sanger-based genotyping method. Lastly, by using a benchtop next-generation sequencer (Roche/454 GS Junior), this approach can be more easily implemented in low-resource settings. This data provides proof

Outcomes of a Clinic-Based, Surveillance-Informed Intervention to Relink Patients to HIV Care

PubMed Central

Bove, Joanna; Golden, Matthew R.; Dhanireddy, Shireesha; Harrington, Robert D.; Dombrowski, Julia C.

2015-01-01

Background Improving patient retention in HIV care is crucial to improving the HIV care continuum. We instituted and evaluated a relinkage program that uses clinical data to identify potentially out-of-care patients, matches those data to public health surveillance, and employs a linkage specialist (LS) to coordinate care relinkage. Methods The intervention began November 1, 2012 in the largest HIV clinic in Washington State. We evaluated program outcomes and compared patient outcomes in the year following initiation of the intervention to a historical control cohort of patients. Cox proportional hazard ratios were used to compare time to relinkage to care between cohorts, and regression models using generalized estimated equations were preformed to examine secondary outcomes of relinkage to care, engagement in care, and viral suppression. Results 753 patients were identified as “out of care” on 11/1/12. Matching with surveillance data and initial LS investigations found that 596 (79%) of these patients had moved, transferred care or were incarcerated. Of the 157 remaining patients: 40 (25%) relinked to care before LS contact, and the LS successfully contacted 38 (24%). A total of 116 (15%) patients in the intervention cohort relinked to care and 24 (20%) were contacted by the LS. Compared to the historical cohort, the time to relinkage was shorter among patients in the intervention cohort [adjusted HR=1.7 (1.2-2.3)] and a greater proportion relinked [15% vs. 10%]. Conclusions This clinic-based, surveillance-informed relinkage intervention showed statistically significant but modest effectiveness in returning out-of-care patients to HIV care compared to historical controls. PMID:26068720

Opportunities for Enhanced Strategic Use of Surveys, Medical Records, and Program Data for HIV Surveillance of Key Populations: Scoping Review

PubMed Central

Baral, Stefan D; Edwards, Jessie K; Zadrozny, Sabrina; Hargreaves, James; Zhao, Jinkou; Sabin, Keith

2018-01-01

Background Normative guidelines from the World Health Organization recommend tracking strategic information indicators among key populations. Monitoring progress in the global response to the HIV epidemic uses indicators put forward by the Joint United Nations Programme on HIV/AIDS. These include the 90-90-90 targets that require a realignment of surveillance data, routinely collected program data, and medical record data, which historically have developed separately. Objective The aim of this study was to describe current challenges for monitoring HIV-related strategic information indicators among key populations ((men who have sex with men [MSM], people in prisons and other closed settings, people who inject drugs, sex workers, and transgender people) and identify future opportunities to enhance the use of surveillance data, programmatic data, and medical record data to describe the HIV epidemic among key populations and measure the coverage of HIV prevention, care, and treatment programs. Methods To provide a historical perspective, we completed a scoping review of the expansion of HIV surveillance among key populations over the past three decades. To describe current efforts, we conducted a review of the literature to identify published examples of SI indicator estimates among key populations. To describe anticipated challenges and future opportunities to improve measurement of strategic information indicators, particularly from routine program and health data, we consulted participants of the Third Global HIV Surveillance Meeting in Bangkok, where the 2015 World Health Organization strategic information guidelines were launched. Results There remains suboptimal alignment of surveillance and programmatic data, as well as routinely collected medical records to facilitate the reporting of the 90-90-90 indicators for HIV among key populations. Studies (n=3) with estimates of all three 90-90-90 indicators rely on cross-sectional survey data. Programmatic data and

HIV risk, prevention, and testing behaviors among men who have sex with men--National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008.

PubMed

Finlayson, Teresa J; Le, Binh; Smith, Amanda; Bowles, Kristina; Cribbin, Melissa; Miles, Isa; Oster, Alexandra M; Martin, Tricia; Edwards, Alicia; Dinenno, Elizabeth

2011-10-28

Approximately 1.1 million persons in the United States are living with human immunodeficiency virus (HIV) infection. More than half of those infected are men who have sex with men (MSM). June-December 2008. The National HIV Behavioral Surveillance (NHBS) System collects risk behavior data from three populations at high risk for HIV infection: MSM, injection-drug users, and heterosexual adults at increased risk for HIV infection. Data for NHBS are collected in rotating cycles. NHBS participants must be aged ≥18 years, live in a participating metropolitan statistical area, and be able to complete a behavioral survey in English or Spanish. Men who reported being infected with HIV or who had no male sex partners during the past 12 months were excluded from this analysis. This report summarizes data gathered from 8,175 MSM during the second data collection cycle of NHBS. In addition to having at least one male sex partner, 14% of participants had at least one female sex partner during the past 12 months. Unprotected anal intercourse with a male partner was reported by 54% of the participants; 37% reported having unprotected anal sex with a main male partner (someone with whom the participant had sex and to whom he felt most committed, such as a boyfriend, spouse, significant other, or life partner), and 25% reported having unprotected anal sex with a casual male partner (someone with whom the participant had sex but with whom he did not feel committed, did not know very well, or had sex with in exchange for something such as money or drugs). Noninjection drug use during the past 12 months was reported by 46% of participants. Specifically, 38% used marijuana, 18% cocaine, 13% poppers (amyl nitrate), and 11% ecstasy. Two percent of the participants reported injecting drugs for nonmedical purposes in the past 12 months. Of the participants surveyed, 90% had been tested for HIV during their lifetime, 62% had been tested during the past 12 months, 51% had received a

Surveillance of HIV antiretroviral drug resistance in treated individuals in England: 1998-2000.

PubMed

Scott, Paul; Arnold, Eve; Evans, Barry; Pozniak, Anton; Moyle, Graeme; Shahmenesh, Mohsen; White, David; Shirley, Jane; Cane, Patricia; Pillay, Deenan

2004-03-01

To establish a surveillance programme for HIV drug resistance within the UK covering the years from 1998 to 2000, following the introduction of triple combination antiretroviral therapy. Sentinel sites included large, medium sized and small clinical centres. Data were analysed until December 2000. Of nearly 300 samples tested, results from 91, 92 and 92 patients, respectively in 1998, 1999 and 2000, who were receiving HIV therapy with a viral load >2000 copies/mL, the majority had viruses with some degree of drug resistance. Overall, the presence of any resistance increased between 1998 and 1999, and fell again in 2000 (69% versus 88% versus 55%). However, major differences were observed between drug classes, such that non-nucleoside analogue reverse transcriptase inhibitor (NNRTI) resistance rose dramatically over the period studied. We show that this correlated with increased NNRTI prescribing. Furthermore, an overall increase in prevalence of viruses with resistance to one or more drugs within all three available classes was observed. A higher prevalence of drug resistance was observed in patients from smaller clinical centres. This is the first such sentinel surveillance dataset from the UK, and is unique in correlating these data with national antiretroviral prescribing patterns. Our findings are relevant to the increased transmission of HIV drug resistance observed over this period.

Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity.

PubMed

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25-6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46-8:52).

Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity

PubMed Central

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53–10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25–6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46–8:52). PMID:26734448

Surveillance of transmitted HIV drug resistance using matched plasma and dried blood spot specimens from voluntary counseling and testing sites in Ho Chi Minh City, Vietnam, 2007-2008.

PubMed

Duc, Nguyen Bui; Hien, Bui Thu; Wagar, Nick; Tram, Tran Hong; Giang, Le Truong; Yang, Chunfu; Wolfe, Mitchell I; Hien, Nguyen Tran; Tuan, Nguyen Anh

2012-05-01

During 2007-2008, surveillance of transmitted human immunodeficiency virus (HIV) drug resistance (TDR) was performed following World Health Organization guidance among clients with newly diagnosed HIV infection attending voluntary counseling and testing (VCT) sites in Ho Chi Minh City (HCMC), Vietnam. Moderate (5%-15%) TDR to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) was observed among VCT clients aged 18-21 years. Follow-up surveillance of TDR in HCMC and other geographic regions of Vietnam is warranted. Data generated will guide the national HIV drug resistance surveillance strategy and support selection of current and future first-line antiretroviral therapy and HIV prevention programs.

HIV testing and intimate partner violence among non-pregnant women in 15 US states/territories: findings from behavioral risk factor surveillance system survey data.

PubMed

Nasrullah, Muazzam; Oraka, Emeka; Breiding, Mathew J; Chavez, Pollyanna R

2013-09-01

Intimate partner violence (IPV) has been shown to be associated with higher rates of HIV infection among women, underscoring the importance of encouraging IPV victims to receive HIV testing. However, we do not know how much HIV testing behavior is influenced by IPV victimization. The current study characterized the association between individual types of IPV and HIV testing in a large sample of non-pregnant women in 15 US states/territories. The 2005 Behavioral Risk Factor Surveillance System data were analyzed after restricting the sample to non-pregnant women. The dependent variable, whether a woman ever had an HIV test, was examined in relation to individual types of IPV victimization (threatened physical violence; attempted physical violence; completed physical violence; and unwanted sex). Associations between HIV testing and types of IPV were assessed using adjusted risk ratios (aRR) that controlled for demographics and HIV-related risk factors (intravenous drug use, sexually transmitted diseases, exchange sex, unprotected anal sex). Approximately 28.6 % of women reported ever having experienced IPV, and 52.8 % of these women reported being tested for HIV. Among women who had not experienced IPV, 32.9 % reported ever having been tested for HIV. HIV testing was associated with lifetime experience of threatened violence (aRR = 1.43; 95 % CI = 1.24-1.65), attempted violence (aRR = 1.43; 95 % CI = 1.20-1.69), completed physical violence (aRR = 1.30; 95 % CI = 1.13-1.48), and unwanted sex (aRR = 1.66; 95 % CI = 1.48-1.86). Women who experienced each type of IPV were more likely to have been ever tested for HIV compared to women with no IPV history. However, nearly half of those reporting IPV, even though at greater risk for HIV infection, had never been tested. Additional efforts are needed to address barriers to testing in this group.

HIV infection and risk, prevention, and testing behaviors among injecting drug users -- National HIV Behavioral Surveillance System, 20 U.S. cities, 2009.

PubMed

Broz, Dita; Wejnert, Cyprian; Pham, Huong T; DiNenno, Elizabeth; Heffelfinger, James D; Cribbin, Melissa; Krishna, Nevin; Teshale, Eyasu H; Paz-Bailey, Gabriela

2014-07-04

At the end of 2009, an estimated 1,148,200 persons aged ≥13 years were living with human immunodeficiency virus (HIV) infection in the United States. Despite the recent decreases in HIV infection attributed to injection drug use, 8% of new HIV infections in 2010 occurred among injecting drug users (IDUs). June-December 2009. The National HIV Behavioral Surveillance System (NHBS) collects HIV prevalence and risk behavior data in selected metropolitan statistical areas (MSAs) from three populations at high risk for HIV infection: men who have sex with men, IDUs, and heterosexual adults at increased risk for HIV infection. Data for NHBS are collected in rotating cycles. For the 2009 NHBS cycle, IDUs were recruited in 20 participating MSAs using respondent-driven sampling, a peer-referral sampling method. Participants were eligible if they were aged ≥18 years, lived in a participating MSA, were able to complete a behavioral survey in English or Spanish, and reported that they had injected drugs during the past 12 months. Consenting participants completed an interviewer-administered (face-to-face), anonymous standardized questionnaire about HIV-associated behaviors, and all participants were offered anonymous HIV testing. Analysis of 2009 NHBS data represents the first large assessment of HIV prevalence among IDUs in the United States in >10 years. This report summarizes two separate analyses using unweighted data from 10,200 eligible IDUs in 20 MSAs from the second collection cycle of NHBS in 2009. Both an HIV infection analysis and a behavioral analysis were conducted. Different denominators were used in each analysis because of the order and type of exclusion criteria applied. For the HIV infection analysis, of the 10,200 eligible participants, 10,090 had a valid HIV test result, of whom 906 (9%) tested positive for HIV (range: 2%-19% by MSA). When 509 participants who reported receiving a previous positive HIV test result were excluded from this analysis, 4

Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

PubMed

Jacobson, Jerry O; Cueto, Carmen; Smith, Jennifer L; Hwang, Jimee; Gosling, Roly; Bennett, Adam

2017-01-18

To eliminate malaria, malaria programmes need to develop new strategies for surveillance and response appropriate for the changing epidemiology that accompanies transmission decline, in which transmission is increasingly driven by population subgroups whose behaviours place them at increased exposure. Conventional tools of malaria surveillance and response are likely not sufficient in many elimination settings for accessing high-risk population subgroups, such as mobile and migrant populations (MMPs), given their greater likelihood of asymptomatic infections, illegal risk behaviours, limited access to public health facilities, and high mobility including extended periods travelling away from home. More adaptive, targeted strategies are needed to monitor transmission and intervention coverage effectively in these groups. Much can be learned from HIV programmes' experience with "second generation surveillance", including how to rapidly adapt surveillance and response strategies to changing transmission patterns, biological and behavioural surveys that utilize targeted sampling methods for specific behavioural subgroups, and methods for population size estimation. This paper reviews the strategies employed effectively for HIV programmes and offers considerations and recommendations for adapting them to the malaria elimination context.

HIV drug resistance surveillance for prioritizing treatment in resource-limited settings

PubMed Central

Walensky, Rochelle P.; Weinstein, Milton C.; Yazdanpanah, Yazdan; Losina, Elena; Mercincavage, Lauren M.; Touré, Siaka; Divi, Nomita; Anglaret, Xavier; Goldie, Sue J.; Freedberg, Kenneth A.

2008-01-01

Background Sentinel testing programs for HIV drug resistance in resource-limited settings can inform policy on antiretroviral therapy (ART) and drug sequencing. Objective To examine the value of resistance surveillance in influencing recommendations toward effective and cost-effective sequencing of ART regimens. Methods A state-transition model of HIV infection was adapted to simulate clinical care in Côte d’Ivoire and evaluate the incremental cost-effectiveness of (1) no ART; (2) ART beginning with a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen followed by a boosted protease inhibitor (PI)-based regimen; and (3) ART beginning with a boosted PI-based regimen followed by an NNRTI-based regimen. Results At a 5% prevalence of NNRTI resistance, a strategy that started with a PI-based regimen had a smaller health benefit and higher cost-effectiveness ratio than a strategy that started with an NNRTI-based regimen (cost-effectiveness ratio $910/year of life saved). Results consistently favored initiation with an NNRTI-based regimen, regardless of the population prevalence of NNRTI resistance (up to 76%) and the efficacy of an NNRTI-based regimen in the setting of resistance. The most influential parameters on the cost-effectiveness of sequencing strategies were boosted PI-based regimen costs and the efficacy of this regimen when used as second-line therapy. Conclusions Drug costs and treatment efficacies, but not NNRTI resistance levels, were most influential in determining optimal HIV drug sequencing in Côte d’Ivoire. Results of surveillance for NNRTI resistance should not be used as a major guide to treatment policy in resource-limited settings. PMID:17457091

Evaluating Behavioral Health Surveillance Systems.

PubMed

Azofeifa, Alejandro; Stroup, Donna F; Lyerla, Rob; Largo, Thomas; Gabella, Barbara A; Smith, C Kay; Truman, Benedict I; Brewer, Robert D; Brener, Nancy D

2018-05-10

In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. Data from public health surveillance systems on drug and alcohol abuse are crucial for developing and evaluating interventions to prevent and control such behavior. However, public health surveillance for behavioral health in the United States has been hindered by organizational issues and other factors. For example, existing guidelines for surveillance evaluation do not distinguish between data systems that characterize behavioral health problems and those that assess other public health problems (eg, infectious diseases). To address this gap in behavioral health surveillance, we present a revised framework for evaluating behavioral health surveillance systems. This system framework builds on published frameworks and incorporates additional attributes (informatics capabilities and population coverage) that we deemed necessary for evaluating behavioral health-related surveillance. This revised surveillance evaluation framework can support ongoing improvements to behavioral health surveillance systems and ensure their continued usefulness for detecting, preventing, and managing behavioral health problems.

Evaluating Behavioral Health Surveillance Systems

PubMed Central

Azofeifa, Alejandro; Lyerla, Rob; Largo, Thomas; Gabella, Barbara A.; Smith, C. Kay; Truman, Benedict I.; Brewer, Robert D.; Brener, Nancy D.

2018-01-01

In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. Data from public health surveillance systems on drug and alcohol abuse are crucial for developing and evaluating interventions to prevent and control such behavior. However, public health surveillance for behavioral health in the United States has been hindered by organizational issues and other factors. For example, existing guidelines for surveillance evaluation do not distinguish between data systems that characterize behavioral health problems and those that assess other public health problems (eg, infectious diseases). To address this gap in behavioral health surveillance, we present a revised framework for evaluating behavioral health surveillance systems. This system framework builds on published frameworks and incorporates additional attributes (informatics capabilities and population coverage) that we deemed necessary for evaluating behavioral health–related surveillance. This revised surveillance evaluation framework can support ongoing improvements to behavioral health surveillance systems and ensure their continued usefulness for detecting, preventing, and managing behavioral health problems. PMID:29752804

Rewriting the narrative of the epidemiology of HIV in sub-Saharan Africa.

PubMed

Baral, Stefan; Phaswana-Mafuya, Nancy

2012-01-01

The fight against HIV remains complicated with contracting donor resources and high burden of HIV among reproductive age adults still often limiting independent economic development. In the widespread HIV epidemics of sub-Saharan Africa (SSA), it is proposed that key populations with specific HIV acquisition and transmission risk factors, such as men who have sex with men (MSM), female sex workers (FSW), and people who use drugs (PUD), are less relevant because HIV transmission is sustained in the general population with average HIV acquisition and transmission risks. However, the understanding that key populations are less relevant in the epidemics of Africa is based on the surveillance system from which these populations are mostly excluded. Outside of SSA, the epidemics of HIV are generally concentrated in the same populations that are excluded from the primary HIV surveillance systems in SSA. The manuscripts included in this special issue present convincing data that FSW, MSM, and PUD carry disproportionate burdens of HIV wherever studied in SSA, are underrepresented in HIV programs and research, and require specific HIV prevention services. These manuscripts collectively suggest that the only effective path forward is one that transcends denial and stigma and focuses on systematically collecting data on all populations at risk for HIV. In addition, there is a need to move to a third generation of HIV surveillance as the current one inadvertently devalues HIV surveillance among key populations in the context of widespread HIV epidemics. Overall, the data reviewed here demonstrate that the dynamics of HIV in Africa are complex and achieving an AIDS-free generation necessitates acceptance of that complexity in all HIV surveillance, research, and prevention, treatment, and care programs.

Effect of Recombination in the Evolutionary Dynamics of HIV under the Surveillance of Immune System

NASA Astrophysics Data System (ADS)

Peng, Weiqun; Yang, Wenjing; Wang, Guanyu

2009-03-01

Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS), which has become one of the most destructive pandemics in history. The fact that HIV virus evolves very fast plays a central role in AIDS immunopathogenesis and the difficulty we face in finding a cure or a vaccine for AIDS. A distinguishing feature of HIV is its high frequency of recombination. The effect of recombination in the HIV evolution is not clear. We establish a mathematical model of the evolutionary dynamics. This model incorporates both point mutation and recombination for genetic diversity, and employs a fitness function developed by Wang and Deem (PRL 97, 188106, 2006) that accounts for the effect of immune system. Using this model, we explore the role of recombination in the battle between the virus population and the immune system, with a special focus on the condition under which recombination helps the virus population to escape from the immune system.

Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011.

PubMed

Belza, M J; Hoyos, J; Fernández-Balbuena, S; Diaz, A; Bravo, M J; de la Fuente, L

2015-04-09

We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had <350 CD4 HIV prevalence was substantially lower than in EPI-VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.

Do HIV Prevalence Trends in ANC Surveillance Represent Trends in the General Population in the ART Era? The Case of Manicaland, East Zimbabwe

PubMed Central

Gregson, Simon; Dharmayat, Kanika; Pereboom, Monique; Takaruza, Albert; Mugurungi, Owen; Schur, Nadine; Nyamukapa, Constance A.

2016-01-01

Objective National estimates of HIV trends in generalised epidemics rely on HIV prevalence data from antenatal clinic (ANC) surveillance. We investigate whether HIV prevalence trends in ANC data reflect trends in men and women in the general population during the scale-up of anti-retroviral treatment (ART) in Manicaland, Zimbabwe. Methods Trends in HIV prevalence in local ANC attendees and adults aged 15-49yrs in towns, agricultural estates, and villages were compared using five rounds of parallel ANC (N≈1,200) and general-population surveys (N≈10,000) and multi-variable log-linear regression. Changes in the age-pattern of HIV prevalence and the age-distribution of ANC attendees were compared with those in the general population. Age-specific pregnancy prevalence rates were compared by HIV infection and ART status. Results Cumulatively, from 1998-2000 to 2009-2011, HIV prevalence fell by 60.0% (95% CI, 51.1%-67.3%) in ANC surveillance data and by 34.3% (30.8%-37.7%) in the general population. Most of the difference arose following the introduction of ART (2006-2011). The estates and villages reflected this overall pattern but HIV prevalence in the towns was lower at local ANCs than in the general population, largely due to attendance by pregnant women from outlying (lower prevalence) areas. The ageing of people living with HIV in the general population (52.4% aged >35yrs, 2009-2011) was under-represented in the ANC data (12.6%) due to lower fertility in older and HIV-infected women. Conclusion After the introduction of ART in Manicaland, HIV prevalence declined more steeply in ANC surveillance data than in the general population. Models used for HIV estimates must reflect this change in bias. PMID:26372390

An 11-Year Surveillance of HIV Type 1 Subtypes in Nagoya, Japan.

PubMed

Fujisaki, Seiichiro; Ibe, Shiro; Hattori, Junko; Shigemi, Urara; Fujisaki, Saeko; Shimizu, Kayoko; Nakamura, Kazuyo; Yokomaku, Yoshiyuki; Mamiya, Naoto; Utsumi, Makoto; Hamaguchi, Motohiro; Kaneda, Tsuguhiro

2009-01-01

Abstract To monitor active HIV-1 transmission in Nagoya, Japan, we have been determining the subtypes of HIV-1 infecting therapy-naive individuals who have newly visited the Nagoya Medical Center since 1997. The subtypes were determined by phylogenetic analyses using the base sequences in three regions of the HIV-1 genes including gag p17, pol protease (PR) and reverse transcriptase (RT), and env C2V3. Almost all HIV-1 subtypes from 1997 to 2007 and 93% of all HIV-1 isolates in 2007 were subtype B. HIV-1 subtypes A, C, D, and F have been detected sporadically since 1997, almost all in Africans and South Americans. The first detected circulating recombinant form (CRF ) was CRF01_AE (11-year average annual detection rate, 7.7%). Only two cases of CRF02_AG were detected in 2006. A unique recombinant form (URF ) was first detected in 1998 and the total number of URFs reached 25 by year 2007 (average annual detection rate, 4.7%). Eleven of these 25 were detected from 2000 to 2005 and had subtypes AE/B/AE as determined by base sequencing of the gag p17, pol PR and RT, and env C2V3 genes (average annual detection rate, 3.7%). Unique subtype B has been detected in six cases since 2006. All 17 of these patients were Japanese. Other recombinant HIV-1s have been detected intermittently in eight cases since 1998. During the 11-year surveillance, most HIV-1s in Nagoya, Japan were of subtype B. We expect that subtype B HIV-1 will continue to predominate for the next several years. Active recombination between subtype B and CRF01_AE HIV-1 and its transmission were also shown.

Assessing and adjusting for differences between HIV prevalence estimates derived from national population-based surveys and antenatal care surveillance, with applications for Spectrum 2013

PubMed Central

Marsh, Kimberly; Mahy, Mary; Salomon, Joshua A.; Hogan, Daniel R.

2014-01-01

Objective(s): To assess differences between HIV prevalence estimates derived from national population surveys and antenatal care (ANC) surveillance sites and to improve the calibration of ANC-derived estimates in Spectrum 2013 to more appropriately account for differences between these data. Design: Retrospective analysis of national population survey and ANC surveillance data from 25 countries with generalized epidemics in sub-Saharan Africa and 8 countries with concentrated epidemics. Methods: Adult national population survey and ANC surveillance HIV prevalence estimates were compared for all available national population survey data points for the years 1999–2012. For sub-Saharan Africa, a mixed-effects linear regression model determined whether the relationship between national population and ANC estimates was constant across surveys. A new calibration method was developed to incorporate national population survey data directly into the likelihood for HIV prevalence in countries with generalized epidemics. Results were used to develop default rules for adjusting ANC data for countries with no national population surveys. Results: ANC surveillance data typically overestimate population prevalence, although a wide variation, particularly in rural areas, is observed across countries and survey years. The new calibration method yields similar point estimates to previous approaches, but leads to an average 44% increase in the width of 95% uncertainty intervals. Conclusion: Important biases remain in ANC surveillance data for HIV prevalence. The new approach to model-fitting in Spectrum 2013 more appropriately accounts for this bias when producing national estimates in countries with generalized epidemics. In countries with concentrated epidemics, local sex ratios should be used to calibrate ANC surveillance estimates. PMID:25203158

Translating knowledge from Pakistan's second generation surveillance system to other global contexts.

PubMed

Adrien, Alix; Thompson, Laura H; Archibald, Chris P; Sandstrom, Paul A; Munro, Michelle; Emmanuel, Faran; Blanchard, James F

2013-09-01

From 2004 to 2011, a collaborative project was undertaken to enhance the capacity of the Government of Pakistan to implement an effective second-generation surveillance system for HIV/AIDS, known as the HIV/AIDS Surveillance Project (HASP). In four separate rounds, behavioural questionnaires were administered among injection drug users, and female, male and hijra (transgender) sex workers. Dried blood spots were collected for HIV testing. Through interviews with project staff in Pakistan and Canada, we have undertaken a critical review of the role of HASP in generating, using and translating knowledge, with an emphasis on capacity building within both the donor and recipient countries. We also documented ongoing and future opportunities for the translation of knowledge produced through HASP. Knowledge translation activities have included educational workshops and consultations held in places as diverse as Colombia and Cairo, and the implementation of HASP methodologies in Asia, the Middle East and sub-Saharan Africa. HASP methodologies have been incorporated in multiple WHO reports. Importantly, the donor country, Canada, has benefited in significant ways from this partnership. Operational and logistical lessons from HASP have, in turn, improved how surveillance is performed in Canada. Through this project, significant capacity was built among the staff of HASP, non-governmental organisations which were engaged as implementation partners, data coordination units which were established in each province, and in the laboratory. As is to be expected, different organisations have different agendas and priorities, requiring negotiation, at times, to ensure the success of collaborative activities. Overall, there has been considerable interest in and opportunities made for learning about the methodologies and approaches employed by HASP. Generally, the recognition of the strengths of the approaches and methodologies used by HASP has ensured an appetite for opportunities of

Trends in HIV infection surveillance data among men who have sex with men in Norway, 1995-2011

PubMed Central

2013-01-01

Background Recent reports on the growing HIV epidemic among men who have sex with men (MSM) in the EU/EEA area were accompanied by an increase of reported HIV among MSM in Oslo, Norway in 2003. Our study with data from 1995 to 2011 has described the recent trends of HIV among MSM in Norway and their socio-demographic and epidemiological characteristics. Methods The data were collected from the Norwegian Surveillance System for Communicable Diseases. Cases were described by age, place of infection, clinical presentation of HIV infection, STI co-infection and source partner. We used simple linear regression to estimate trends over time. Results During the study period, 991 MSM, aged from 16 to 80 years, were newly diagnosed with HIV. No significant trends over time in overall median age (36 years) were observed. Most of the MSM (505, 51%) were infected in Oslo. In the years 1995-2002, 30 to 45 MSM were diagnosed with HIV each year, while in the years 2003-2011 this increased to between 56 and 97 cases. The proportion of MSM, presenting with either AIDS or HIV illness, decreased over time, while asymptomatic and acute HIV illness increased (p for trend=0.034 or less). STI co-infection was reported in 133 (13%) cases. An overall increase of syphilis co-infected cases was observed (p for trend <0.001). A casual partner was a source of infection in 590 cases (60%). Conclusions Though the increases described could be attributed to earlier testing and diagnosis, no change in the median age of cases was observed. This indicates that it is likely that there has been an increase in HIV infections among MSM in Norway since 2003. The simultaneous increase in STI co-infections indicates risky sexual behaviour and a potential to spread both HIV and other sexually transmitted infections. PMID:23414557

Sociobehavioral correlates of HIV risk among men who have sex with men in Chhattisgarh, India: analysis of sentinel surveillance data.

PubMed

Saha, Malay Kumar; Mahapatra, Tanmay; Biswas, Subrata; Ghosh, Piyali; Mahapatra, Sanchita; Deb, Aloke Kumar; Diwan, Kshitiz

2015-01-01

Men who have sex with men (MSM) in India are mostly hidden due to stigma and discrimination and are at a higher risk of acquiring human immunodeficiency virus (HIV). HIV Sentinel Surveillance (HSS) reported an increased HIV burden in Chhattisgarh, an important state in central India. This state has the distinction of having the highest HIV prevalence among MSM in India; therefore, it warrants special attention; hence, we focused on the role of MSM in the HIV epidemic in this state. Cross-sectional analysis of the most recent latest (2010-2011) HSS data of 227 MSM in Chhattisgarh revealed a HIV seropositivity of 14.98%. Older age, unemployment, and receiving money for sex with a man were associated with a higher HIV risk. Participants were mostly young (mean age, approximately 26 years), school-level educated (51.98%), urban residents (99.56%), in service (46.26%), not involved in heterosexual activity (97.36%), or paid sex (68.72%). None of the participants reported injection drug use, and almost all of them (98.68%) were kothis. Some of the observed associations lacked statistical power due to sparse data obtained during this initial surveillance among MSM in Chhattisgarh. Therefore, further studies involving a larger population are needed to understand the role of MSM in the dynamics of the HIV epidemic in this state to facilitate the planning of appropriate interventions, as the epidemic is likely to be concentrated among MSM in Chhattisgarh.

Trends in use of health care and HIV prevention services for persons who inject drugs in San Francisco: results from National HIV Behavioral Surveillance 2005-2012.

PubMed

Coffin, Phillip O; Jin, Harry; Huriaux, Emalie; Mirzazadeh, Ali; Raymond, Henry F

2015-01-01

Multiple developments addressing health of people who inject drugs (PWIDs) in San Francisco were initiated from 2003 to 2012, including expanded health care coverage, syringe access, HIV testing and universal HIV treatment. We evaluated 3 PWID cycles of the National HIV Behavioral Surveillance for several healthcare measures related to the expanded services. Using RDSAT estimators, we applied the Cochran-Armitage test for trend to evaluate signals of improvement during the time in which health system changes were made. Participant demographics were similar (n=565, 535, and 570 in 2005, 2009, and 2012, respectively). There was a substantial increase in healthcare coverage (37.6 to 82.5%, P<0.0001). Obtaining syringes from pharmacies (17.8 to 32.1%, P<0.0001) increased substantially. Past year hepatitis C testing increased (16.5 to 33.1%, P<0.0001) with stable self-reported prevalence (45.7-54.2%, P=0.8). Among those with known HIV, antiretroviral treatment was reported among 46.6% in 2005 and 66.3% in 2012. Past year HIV testing declined from 74.2 to 42.1%, (P<0.0001) and the prevalence of unrecognized HIV among PWIDs was 42.2-42.7% in 2009 and 2012. There is evidence of improvement in some health measures for PWIDs in San Francisco from 2005 to 2012. However, there are also some concerning findings, such as declining prevalence of HIV testing and high prevalence of undiagnosed HIV. There is a need for renewed attention and innovative ideas to track and address HIV and other medical sequelae among PWIDs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Sharply rising prevalence of HIV infection in Bali: a critical assessment of the surveillance data.

PubMed

Januraga, P P; Wulandari, L P L; Muliawan, P; Sawitri, S; Causer, L; Wirawan, D N; Kaldor, J M

2013-08-01

This study critically examines serological survey data for HIV infection in selected populations in Bali, Indonesia. Sero-survey data reported by the Bali Health Office between 2000 and 2010 were collated, and provincial health staff were interviewed to gain a detailed understanding of survey methods. Analysis of time series restricted to districts that have used the same sampling methods and sites each year indicates that there has been a steady decline in HIV prevalence among prisoners, from 18.7% in 2000 to 4.3% in 2010. In contrast, HIV prevalence among women engaged in sex work increased sharply: from 0.62% in 2000 to 20.2% in 2010 (brothel based), and from 0% in 2000 to 7.2% in 2010 (non-brothel based). The highest prevalence was recorded among people who injected drugs. Recent surveys of gay men and transvestites also found high prevalences, at 18.7% and 40.9%, respectively. Review of the methodology used in the surveys identified inconsistencies in the sampling technique, sample numbers and sites over time, and incomplete recording of individual information about survey participants. Attention to methodological aspects and incorporation of additional information on behavioural factors will ensure that the surveillance system is in the best position to support prevention activities.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) case reporting in the World Health Organization European Region in 2006.

PubMed

Devaux, I; Alix, J; Likatavicius, G; Herida, M; Nielsen, S S; Hamers, F F; Nardone, A

2008-09-25

This article presents information on HIV and AIDS case reporting systems as part of a survey on HIV/AIDS surveillance practices in the World Health Organization (WHO) European Region. A standardised questionnaire was sent to the 53 national correspondents of the European Centre for the Epidemiological Monitoring of AIDS(EuroHIV). The HIV and AIDS case reporting section of the questionnaire comprised four parts: data collection system, HIV/AIDS case definition for surveillance, variables collected, and evaluation of surveillance systems). Individual-based data collection systems for HIV case reports have been implemented in 43 of 44 countries in the WHO European Region and for AIDS case reports in all the countries. For HIV case reports, a coded identifier is used in 28 countries, and full names are used in 11 countries. The European AIDS case definition has been adopted in 35 countries(80%). Information on molecular epidemiology is available in 30 countries, and HIV drug resistance is monitored in 11 countries.HIV/AIDS case reporting systems have been evaluated for underreporting in 17 countries and for completeness in 11 countries.This article outlines the future needs for HIV/AIDS surveillance and presents recommendations on how to improve data comparability across European countries in the WHO region.

NATIONAL ELECTRONIC DISEASE SURVEILLANCE SYSTEM (NEDSS)

EPA Science Inventory

The National Electronic Disease Surveillance System (NEDSS) project is a public health initiative to provide a standard-based, integrated approach to disease surveillance and to connect public health surveillance to the burgeoning clinical information systems infrastructure. NEDS...

Improving the Representativeness of Behavioral and Clinical Surveillance for Persons with HIV in the United States: The Rationale for Developing a Population-Based Approach

PubMed Central

McNaghten, A. D.; Wolfe, Mitchell I.; Onorato, Ida; Nakashima, Allyn K.; Valdiserri, Ronald O.; Mokotoff, Eve; Romaguera, Raul A.; Kroliczak, Alice; Janssen, Robert S.; Sullivan, Patrick S.

2007-01-01

The need for a new surveillance approach to understand the clinical outcomes and behaviors of people in care for HIV evolved from the new challenges for monitoring clinical outcomes in the HAART era, the impact of the epidemic on an increasing number of areas in the US, and the need for representative data to describe the epidemic and related resource utilization and needs. The Institute of Medicine recommended that the Centers for Disease Control and Prevention and the Heath Resources and Services Administration coordinate efforts to survey a random sample of HIV-infected persons in care, in order to more accurately measure the need for prevention and care services. The Medical Monitoring Project (MMP) was created to meet these needs. This manuscript describes the evolution and design of MMP, a new nationally representative clinical outcomes and behavioral surveillance system, and describes how MMP data will be used locally and nationally to identify care and treatment utilization needs, and to plan for prevention interventions and services. PMID:17579722

Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data

PubMed Central

Terzian, Arpi; Opoku, Jenevieve; Happ, Lindsey Powers; Younes, Naji; Kharfen, Michael; Greenberg, Alan

2018-01-01

Background Triangulation of data from multiple sources such as clinical cohort and surveillance data can help improve our ability to describe care patterns, service utilization, comorbidities, and ultimately measure and monitor clinical outcomes among persons living with HIV infection. Objectives The objective of this study was to determine whether linkage of clinical cohort data and routinely collected HIV surveillance data would enhance the completeness and accuracy of each database and improve the understanding of care patterns and clinical outcomes. Methods We linked data from the District of Columbia (DC) Cohort, a large HIV observational clinical cohort, with Washington, DC, Department of Health (DOH) surveillance data between January 2011 and June 2015. We determined percent concordance between select variables in the pre- and postlinked databases using kappa test statistics. We compared retention in care (RIC), viral suppression (VS), sexually transmitted diseases (STDs), and non-HIV comorbid conditions (eg, hypertension) and compared HIV clinic visit patterns determined using the prelinked database (DC Cohort) versus the postlinked database (DC Cohort + DOH) using chi-square testing. Additionally, we compared sociodemographic characteristics, RIC, and VS among participants receiving HIV care at ≥3 sites versus <3 sites using chi-square testing. Results Of the 6054 DC Cohort participants, 5521 (91.19%) were included in the postlinked database and enrolled at a single DC Cohort site. The majority of the participants was male, black, and had men who have sex with men (MSM) as their HIV risk factor. In the postlinked database, 619 STD diagnoses previously unknown to the DC Cohort were identified. Additionally, the proportion of participants with RIC was higher compared with the prelinked database (59.83%, 2678/4476 vs 64.95%, 2907/4476; P<.001) and the proportion with VS was lower (87.85%, 2277/2592 vs 85.15%, 2391/2808; P<.001). Almost a quarter of

Epidemiological HIV infection surveillance among subjects with risk behaviours in the city of Messina (Sicily) from 1992 to 2015.

PubMed

Visalli, G; Avventuroso, E; Laganà, P; Spataro, P; Di Pietro, A; Bertuccio, M P; Picerno, I

2017-09-01

Epidemiological studies are a key element in determining the evolution and spread of HIV infection among the world population. Knowledge of the epidemiological dynamics improves strategies for prevention and monitoring. We examined 2,272 subjects who voluntarily underwent HIV testing from January 1992 to December 2015. For each subject, an anonymous form was completed to obtain information on personal data, sexual habits and exposure to risk factors. The number of subjects undergoing the screening test has increased over the years and the average age of the tested subjects has decreased over time. The main motivation for undergoing HIV testing is unprotected sex. Although heterosexual subjects taking the test were more numerous than homosexuals in this study, an increase in the latter over time should be highlighted. Although the number of tests performed has increased over the years, the persistence of unprotected sex shows an inadequate perception of risk. Therefore, it is necessary to implement programmes to increase the general awareness of HIV infection. It is also essential to undertake constant monitoring of behaviour, risk perception and the application of the screening test via surveillance systems in order to implement effective and efficient prevention.

Declining HIV Prevalence in Parallel With Safer Sex Behaviors in Burkina Faso: Evidence From Surveillance and Population-Based Surveys.

PubMed

Kirakoya-Samadoulougou, Fati; Nagot, Nicolas; Samadoulougou, Sekou; Sokey, Mamadou; Guiré, Abdoulaye; Sombié, Issiaka; Meda, Nicolas

2016-06-20

To investigate trends in HIV prevalence and changes in reported sexual behaviors between 1998 and 2014 in Burkina Faso. We obtained data on HIV prevalence from antenatal care (ANC) surveillance sites (N = 9) that were consistently included in surveillance between 1998 and 2014. We also analyzed data on HIV prevalence and reported sex behaviors from 3 population-based surveys from the Demographic and Health Surveys (DHS), conducted in 1998-99, 2003, and 2010. Sex behavior indicators comprised never-married youth who have never had sex; sex with more than 1 partner; sex with a nonmarital, non-cohabiting partner; condom use at last sex with a nonmarital, non-cohabiting partner; and sex before age 15. We calculated survey-specific HIV prevalence with 95% confidence intervals (CIs) and used the chi-square test or chi-square test for trend to compare HIV prevalence across survey years and to analyze trends in reported sex behaviors. HIV prevalence among pregnant women ages 15-49 decreased by 72% in urban areas, from 7.1% in 1998 to 2.0% in 2014, and by 75% in rural areas, from 2.0% in 2003 to 0.5% in 2014. HIV declined most in younger age groups, which is a good reflection of recent incidence, with declines of 55% among 15-19-year-olds, 72% among 20-24-year-olds, 40% among 25-29-year-olds, and 7% among those ≥30 years old (considering urban and rural data combined). Data reported in the DHS corroborated these declines in HIV prevalence: between 2003 and 2010, HIV prevalence dropped significantly-by 89% among girls ages 15-19, from 0.9% (95% CI, 0.2 to 1.6) to 0.1% (95% CI, 0.0 to 0.4), and by 78% among young women ages 20-24, from 1.8% (95% CI, 1.6 to 3.0) to 0.4% (95% CI, 0.0 to 0.7). During the same time period, people reported safer sex behaviors. For example, significantly higher percentages of never-married youth reported they had never had sex, lower percentages of sexually active youth reported multiple sex partners, and lower percentages of youth reported

Development of a unified web-based national HIV/AIDS information system in China

PubMed Central

Mao, Yurong; Wu, Zunyou; Poundstone, Katharine; Wang, Changhe; Qin, Qianqian; Ma, Ye; Ma, Wei

2010-01-01

Background In the past, many data collection systems were in operation for different HIV/AIDS projects in China. We describe the creation of a unified, web-based national HIV/AIDS information system designed to streamline data collection and facilitate data use. Methods Integration of separate HIV/AIDS data systems was carried out in three phases. Phase 1, from January 2006 to December 2007, involved creating a set of unified data collection forms that took into account existing program needs and the reporting requirements of various international organizations. Phase 2, from January to October 2007, involved creating a web-based platform to host the integrated HIV/AIDS data collection system. Phase 3, from November to December 2007, involved pilot testing the new, integrated system prior to nationwide application. Results Eight web-based data collection subsystems based on one platform began operation on 1 January 2008. These eight subsystems cover: (i) HIV/AIDS case reporting; (ii) HIV testing and counselling; (iii) antiretroviral treatment (ART) for adults; (iv) ART for children; (v) behavioural interventions for high-risk groups; (vi) methadone maintenance treatment; (vii) sentinel and behavioural surveillance; and (viii) local county background information. The system provides real-time data to monitor HIV testing, prevention and treatment programs across the country. Conclusion China’s new unified, web-based HIV/AIDS information system has improved the efficiency of data collection, reporting, analysis and use, as well as data quality and security. It is a powerful tool to support policy making, program evaluation and implementation of the national HIV/AIDS program and, thus, may serve a model for other countries. PMID:21113041

Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting.

PubMed

Ekegren, Christina L; Donaldson, Alex; Gabbe, Belinda J; Finch, Caroline F

Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be

An integrated national mortality surveillance system for death registration and mortality surveillance, China.

PubMed

Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

2016-01-01

In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

Epidemiological surveillance of HIV-1 transmitted drug resistance among newly diagnosed individuals in Shijiazhuang, northern China, 2014-2015.

PubMed

Wang, Xianfeng; Liu, Xiaosong; Li, Feng; Zhou, Hong; Li, Jiefang; Wang, Yingying; Liu, Lihua; Liu, Shujun; Feng, Yi; Wang, Ning

2018-01-01

The widespread use of antiretroviral therapy (ART) has led to considerable concerns about the prevalence of transmitted drug resistance (TDR). Sexual contact, particularly men who have sex with men (MSM) was the most prevalent form of HIV transmission in Shijiazhuang. Hence, we conducted an epidemiological surveillance study on TDR among newly diagnosed individuals who infected-HIV through sexual contact in from 2014-2015. Genotypic resistance mutations were defined using the WHO-2009 surveillance list. Potential impact on antiretroviral drug was predicted according to the Stanford HIV db program version 7.0. The role of transmission clusters in drug resistant strains was evaluated by phylogenetic and network analyses. In this study, 589 individuals were recruited and 542 samples were amplified and sequenced successfully. The over prevalence of TDR was 6.1%: 1.8% to nucleoside reverse transcriptase inhibitors (NRTIs), 2.0% to non- NRTIs (NNRTIs) and 2.4% to protease inhibitors (PIs), respectively. We did not find significant differences in the TDR prevalence by demographic and clinical characteristics (p > 0.05). Using network and phylogenetic analysis, almost 60.0% sequences were clustered together. Of these clusters, 2 included at least two individuals carrying the same resistance mutation, accounting for 21.2% (7/33) individuals with TDR. No significant difference was observed in the clustering rate between the individuals with and without TDR. We obtained a moderate level TDR rate in studied region. These findings enhance our understanding of HIV-1 drug resistance prevalence in Shijiazhuang, and may be helpful for the comprehensive prevention and control of HIV-1.

Evaluation of data quality, timeliness and acceptability of the tuberculosis surveillance system in Brazil's micro-regions.

PubMed

Silva, Gabriela Drummond Marques da; Bartholomay, Patrícia; Cruz, Oswaldo Gonçalves; Garcia, Leila Posenato

2017-10-01

This study aimed to evaluate quality, acceptability and timeliness of the data in the tuberculosis surveillance system in Brazilian micro-regions. An ecological cross-sectional study was carried out, after a qualitative stage for selecting indicators. All 558 Brazilian micro-regions were used as units of analysis. Data available in the National Notifiable Diseases Information System (SINAN), from 2012 to 2014, were used to calculate 14 indicators relating to four attributes: completeness, consistency, timeliness and acceptability. The study made use of cluster analysis to group micro-regions according to acceptability and timeliness. Three clusters were identified among the 473 micro-regions with optimal or regular completeness (70% to 100%) and with over five notifications. Cluster 1 (n = 109) presented mean timeliness of notification and treatment equal to 62.8% and 24.9%, respectively. Cluster 2 (n = 143) had a mean percentage of cases tested for HIV equal to 55.9%. Cluster 3 (n = 221) had the best performing tuberculosis indicators. Results suggest priority areas for improving surveillance of tuberculosis, predominantly in the central-north part of the country. They also point to the need to increase the timeliness of treatment and the percentage of cases tested for HIV.

Relationship between a Centers for Disease Control and Prevention expanded HIV testing initiative and past-year testing by race/ethnicity: a multilevel analysis of the Behavioral Risk Factor Surveillance System.

PubMed

Gaines, Tommi L; Caldwell, Julia T; Ford, Chandra L; Mulatu, Mesfin S; Godette, Dionne C

2016-01-01

The Centers for Disease Control and Prevention's (CDC) expanded testing initiative (ETI) aims to bolster HIV testing among populations disproportionately affected by the HIV epidemic by providing additional funding to health departments serving these communities. ETI prioritizes testing in clinical settings; therefore, we examined the relationship between state-level ETI participation and past-year HIV testing among a racially/ethnically diverse sample of adult respondents to the 2012 Behavioral Risk Factor Surveillance System who accessed health services within the 12 months prior to being interviewed. Controlling for individual- and state-level characteristics in a multilevel logistic regression model, ETI participation was independently and positively associated with past-year testing, but this association varied by race/ethnicity. Hispanics had higher odds (adjusted odds ratio [AOR]: 1.49; 95% CI: 1.11-2.02) and American Indian/Alaska Natives had lower odds (AOR: 0.66; 95% CI: 0.43-0.99) of testing if they resided in states with (vs. without) ETI participation. State-level ETI participation did not significantly alter past-year testing among other racial/ethnic groups. Prioritizing public health resources in states most affected by HIV can improve testing patterns, but other mechanisms likely influence which racial/ethnic groups undergo testing.

HIV-1 transcriptional regulation in the central nervous system and implications for HIV cure research

PubMed Central

Churchill, Melissa J.; Cowley, Daniel J.; Wesselingh, Steve L.; Gorry, Paul R.; Gray, Lachlan R.

2014-01-01

Human immunodeficiency virus type-1 (HIV-1) invades the central nervous system (CNS) during acute infection which can result in HIV-associated neurocognitive disorders (HAND) in up to 50% of patients, even in the presence of combination antiretroviral therapy (cART). Within the CNS, productive HIV-1 infection occurs in the perivascular macrophages and microglia. Astrocytes also become infected, although their infection is restricted and does not give rise to new viral particles. The major barrier to the elimination of HIV-1 is the establishment of viral reservoirs in different anatomical sites throughout the body and viral persistence during long-term treatment with cART. While the predominant viral reservoir is believed to be resting CD4+ T-cells in the blood, other anatomical compartments including the CNS, gut-associated lymphoid tissue, bone marrow, and genital tract can also harbor persistently infected cellular reservoirs of HIV-1. Viral latency is predominantly responsible for HIV-1 persistence, and is most likely governed at the transcriptional level. Current clinical trials are testing transcriptional activators, in the background of cART, in an attempt to purge these viral reservoirs and reverse viral latency. These strategies aim to activate viral transcription in cells constituting the viral reservoir, so they can be recognized and cleared by the immune system, while new rounds of infection are blocked by co-administration of cART. The CNS has several unique characteristics that may result in differences in viral transcription and in the way latency is established. These include CNS-specific cell types, different transcription factors, altered immune surveillance, and reduced antiretroviral drug bioavailability. A comprehensive understanding of viral transcription and latency in the CNS is required in order to determine treatment outcomes when using transcriptional activators within the CNS. PMID:25060300

DoD Global Emerging Infections Surveillance & Response System (DoD-GEIS). Global Influenza Surveillance Efforts

DTIC Science & Technology

2007-01-08

DoD Global Emerging Infections Surveillance & Response System (DoD-GEIS) Global Influenza Surveillance Efforts 8 January 2007 COL (Ret.) Jose L...SUBTITLE DoD Global Emerging Infections Surveillance & Response System (DoD-GEIS) Global Influenza Surveillance Efforts 5a. CONTRACT NUMBER 5b. GRANT...PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Lab-Based Influenza Surveillance • Sentinel Surveillance • Air Force

Smart sensing surveillance video system

NASA Astrophysics Data System (ADS)

Hsu, Charles; Szu, Harold

2016-05-01

An intelligent video surveillance system is able to detect and identify abnormal and alarming situations by analyzing object movement. The Smart Sensing Surveillance Video (S3V) System is proposed to minimize video processing and transmission, thus allowing a fixed number of cameras to be connected on the system, and making it suitable for its applications in remote battlefield, tactical, and civilian applications including border surveillance, special force operations, airfield protection, perimeter and building protection, and etc. The S3V System would be more effective if equipped with visual understanding capabilities to detect, analyze, and recognize objects, track motions, and predict intentions. In addition, alarm detection is performed on the basis of parameters of the moving objects and their trajectories, and is performed using semantic reasoning and ontologies. The S3V System capabilities and technologies have great potential for both military and civilian applications, enabling highly effective security support tools for improving surveillance activities in densely crowded environments. It would be directly applicable to solutions for emergency response personnel, law enforcement, and other homeland security missions, as well as in applications requiring the interoperation of sensor networks with handheld or body-worn interface devices.

Web surveillance system using platform-based design

NASA Astrophysics Data System (ADS)

Lin, Shin-Yo; Tsai, Tsung-Han

2004-04-01

A revolutionary methodology of SOPC platform-based design environment for multimedia communications will be developed. We embed a softcore processor to perform the image compression in FPGA. Then, we plug-in an Ethernet daughter board in the SOPC development platform system. Afterward, a web surveillance platform system is presented. The web surveillance system consists of three parts: image capture, web server and JPEG compression. In this architecture, user can control the surveillance system by remote. By the IP address configures to Ethernet daughter board, the user can access the surveillance system via browser. When user access the surveillance system, the CMOS sensor presently capture the remote image. After that, it will feed the captured image with the embedded processor. The embedded processor immediately performs the JPEG compression. Afterward, the user receives the compressed data via Ethernet. To sum up of the above mentioned, the all system will be implemented on APEX20K200E484-2X device.

System For Surveillance Of Spectral Signals

DOEpatents

Gross, Kenneth C.; Wegerich, Stephan W.; Criss-Puszkiewicz, Cynthia; Wilks, Alan D.

2004-10-12

A method and system for monitoring at least one of a system, a process and a data source. A method and system have been developed for carrying out surveillance, testing and modification of an ongoing process or other source of data, such as a spectroscopic examination. A signal from the system under surveillance is collected and compared with a reference signal, a frequency domain transformation carried out for the system signal and reference signal, a frequency domain difference function established. The process is then repeated until a full range of data is accumulated over the time domain and a Sequential Probability Ratio Test ("SPRT") methodology applied to determine a three-dimensional surface plot characteristic of the operating state of the system under surveillance.

System For Surveillance Of Spectral Signals

DOEpatents

Gross, Kenneth C.; Wegerich, Stephan; Criss-Puszkiewicz, Cynthia; Wilks, Alan D.

2003-04-22

A method and system for monitoring at least one of a system, a process and a data source. A method and system have been developed for carrying out surveillance, testing and modification of an ongoing process or other source of data, such as a spectroscopic examination. A signal from the system under surveillance is collected and compared with a reference signal, a frequency domain transformation carried out for the system signal and reference signal, a frequency domain difference function established. The process is then repeated until a full range of data is accumulated over the time domain and a Sequential Probability Ratio Test methodology applied to determine a three-dimensional surface plot characteristic of the operating state of the system under surveillance.

System for surveillance of spectral signals

DOEpatents

Gross, Kenneth C.; Wegerich, Stephan W.; Criss-Puszkiewicz, Cynthia; Wilks, Alan D.

2006-02-14

A method and system for monitoring at least one of a system, a process and a data source. A method and system have been developed for carrying out surveillance, testing and modification of an ongoing process or other source of data, such as a spectroscopic examination. A signal from the system under surveillance is collected and compared with a reference signal, a frequency domain transformation carried out for the system signal and reference signal, a frequency domain difference function established. The process is then repeated until a full range of data is accumulated over the time domain and a Sequential Probability Ratio Test ("SPRT") methodology applied to determine a three-dimensional surface plot characteristic of the operating state of the system under surveillance.

System for surveillance of spectral signals

DOEpatents

Gross, Kenneth C.; Wegerich, Stephan W.; Criss-Puszkiewicz, Cynthia; Wilks, Alan D.

2001-01-01

A method and system for monitoring at least one of a system, a process and a data source. A method and system have been developed for carrying out surveillance, testing and modification of an ongoing process or other source of data, such as a spectroscopic examination. A signal from the system under surveillance is collected and compared with a reference signal, a frequency domain transformation carried out for the system signal and reference signal, a frequency domain difference function established. The process is then repeated until a full range of data is accumulated over the time domain and a SPRT sequential probability ratio test methodology applied to determine a three-dimensional surface plot characteristic of the operating state of the system under surveillance.

2012 Sexually Transmitted Diseases Surveillance

MedlinePlus

... Data Appendix Tables A1 - A4 STD Surveillance Case Definitions Contributors Related Links STD Home STD Data & Statistics NCHHSTP Atlas Interactive STD Data - 1996-2013 STD Health Equity HIV/AIDS Surveillance & Statistics Follow STD STD on Twitter STD on Facebook File Formats Help: How do I view different ...

Cumulative plasma HIV burden disparities among adults in HIV care: implications for HIV transmission in the era of treatment as prevention.

PubMed

Hughes, Alison J; Rector, Amadeia; Jimenez, Veronica; Brock, Jon; Scheer, Susan

2018-06-11

To characterize disparities in cumulative plasma HIV burden in a sample of adults accessing HIV care in San Francisco, California. Observational cohort and supplemental HIV surveillance data. Data from the San Francisco Medical Monitoring Project 2012-2014 cycles and HIV surveillance data were used to create an analytic cohort followed for two years. Matched HIV viral load (VL) test results from HIV surveillance were used to create five viral outcome measures: any unsuppressed VL (>200 copies/mL), any transmittable VL (>1500 copies/mL), person-time spent unsuppressed, person-time spent transmittable, and 2-year viremia copy-years, a measure of cumulative plasma HIV burden. Rao-Scott chi-squares and ANOVA examined differences in durable suppression and mean percent time spent unsuppressed and transmittable. Weighted linear regression was used to describe differences in cumulative HIV burden. Adults receiving HIV care spent approximately 12% of the 2-year time period with an unsuppressed viral load and approximately 7% of the time at a transmittable viral level. Factors independently associated with higher cumulative HIV viremia in an adjusted model included trans female identity, younger age, lower CD4 count, and a history of homelessness, incarceration, not taking ART, and non-adherence to ART. Although 95% of the cohort of adults in HIV care in San Francisco self-reported ART use during MMP interview, they spent on average almost one month per year at a transmittable viral level. We identified characteristics of those who were more likely to have higher viral burden, highlighting priorities for resource allocation to reduce onward HIV transmission.

Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India.

PubMed

Thamattoor, Usha; Thomas, Tinku; Banandur, Pradeep; Rajaram, S; Duchesne, Thierry; Abdous, Belkacem; Washington, Reynold; Ramesh, B M; Moses, Stephen; Alary, Michel

2015-01-01

Heterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC) attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively. Data on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO) between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs) conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity. The average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA) districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age ≥ 25 years [adjusted odds ratio (AOR):1.49; 95% confidence interval (95%CI):1.27 to 1.76] compared to those with age<25 years; illiterate (AOR:1.62; 95%CI:1.03 to 2.54) compared to literate; employed in agriculture (AOR:1.34; 95%CI:1.11 to 1.62) or with occupations like driver/helper/industry/factory workers/hotel staff (AOR:1.59; 95%CI:1.26 to 2.01) compared to unemployed. District level HIV prevalence among FSWs (AOR:1.03; 95%CI:1.0 to 1.05) and percentage women marrying under 18 years were significantly associated with ANC-HIV positivity (AOR:1.02; 95%CI:1.00 to 1.04). Illiteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV preventive interventions among FSWs

Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India

PubMed Central

Thamattoor, Usha; Thomas, Tinku; Banandur, Pradeep; S, Rajaram; Duchesne, Thierry; Abdous, Belkacem; Washington, Reynold; B M, Ramesh; Moses, Stephen; Alary, Michel

2015-01-01

Background Heterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC) attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively. Methods Data on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO) between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs) conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity. Results The average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA) districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age≥25 years [adjusted odds ratio (AOR):1.49; 95% confidence interval (95%CI):1.27 to 1.76] compared to those with age<25 years; illiterate (AOR:1.62; 95%CI:1.03 to 2.54) compared to literate; employed in agriculture (AOR:1.34; 95%CI:1.11 to 1.62) or with occupations like driver/helper/industry/factory workers/hotel staff (AOR:1.59; 95%CI:1.26 to 2.01) compared to unemployed. District level HIV prevalence among FSWs (AOR:1.03; 95%CI:1.0 to 1.05) and percentage women marrying under 18 years were significantly associated with ANC-HIV positivity (AOR:1.02; 95%CI:1.00 to 1.04). Conclusion Illiteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV

Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic.

PubMed

Slogrove, Amy L; Mahy, Mary; Armstrong, Alice; Davies, Mary-Ann

2017-05-16

With increasing survival of vertically HIV-infected children and ongoing new horizontal HIV infections, the population of adolescents (age 10-19 years) living with HIV is increasing. This review aims to describe the epidemiology of the adolescent HIV epidemic and the ability of national monitoring systems to measure outcomes in HIV-infected adolescents through the adolescent transition to adulthood. Differences in global trends between younger (age 10-14 years) and older (age 15-19 years) adolescents in key epidemic indicators are interrogated using 2016 UNAIDS estimates. National population-based survey data in the 15 highest adolescent HIV burden countries are evaluated and examples of national case-based surveillance systems described. Finally, we consider the potential impact of adolescent-specific recommendations in the 2016 WHO Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. UNAIDS estimates indicate the population of adolescents living with HIV is increasing, new HIV infections in older adolescents are declining, and while AIDS-related deaths are beginning to decline in younger adolescents, they are still increasing in older adolescents. National population-based surveys provide valuable estimates of HIV prevalence in older adolescents and recent surveys include data on younger adolescents. Only a few countries have nationwide electronic case-based HIV surveillance, with the ability to provide population-level data on key HIV outcomes in the diagnosed population living with HIV. However, in the 15 highest adolescent HIV burden countries, there are no systems tracking adolescent transition to adulthood or healthcare transition. The strength of the 2016 WHO adolescent-specific recommendations on antiretroviral therapy and provision of HIV services to adolescents was hampered by the lack of evidence specific to this age group. Progress is being made in national surveillance and global monitoring systems

HIV and AIDS, other sexually transmitted diseases, and tuberculosis in ethnic minorities in United Kingdom: is surveillance serving its purpose?

PubMed Central

De Cock, K. M.; Low, N.

1997-01-01

Experience of disease differs across ethnic groups, and ethnicity is a relevant personal characteristic for descriptive epidemiology. Information about ethnicity and country of birth is omitted from the routine notification of many diseases. HIV infection and AIDS, other sexually transmitted diseases, and tuberculosis have different incidence rates in different ethnic groups in the United Kingdom. Omission of ethnic data from surveillance activities allows such differences in incidence to go undetected and unaddressed. Surveillance data that included ethnic details could guide interventions to reduce inequalities in health between different subpopulations. PMID:9202508

[Analysis on bacillary dysentery surveillance data collected from the National Surveillance System in 2007.].

PubMed

Zhong, Hao-jie; Chang, Zhao-rui; Zhang, Jing

2010-03-01

To improve the national surveillance plan on bacillary dysentery and to increase the sensitivity of the surveillance system on the disease. Data was collected through China Disease Reporting Information System (CDRIS) and National Sentinel Surveillance Sites on bacillary dysentery. Data from the CDRIS was compared with the data from the National Sentinel Surveillance to identify the exiting problems. Data from the monitoring sites showed that the detection rate of infant cases of bacillary dysentery infection was 1%, less than that of other age groups. The highest rates were seen in children aged 3 through 9 years. Rate on misdiagnosis in all age group was 23.38%, when using the surveillance case definition of clinical cases and suspect case. The rate of misdiagnosis on infant cases of bacillary dysentery infection by clinical diagnosis was 50%. It showed that Shigella flexneri and Shigella sonnei were dominant with the positive rates as 57.21% and 42.41%, respectively. From the national sentinel surveillance sites, the confirmed cases taking up 43.39% which did not match the figure from the CDRIS. The diagnostic criterion for bacillary dysentery fit well on other age groups in surveillance system except on infants. Active surveillance on bacillary dysentery that combining both clinical and laboratory diagnosis seems quite necessary on CDRIS, especially for infants.

High Prevalence of HIV Drug Resistance Among Newly Diagnosed Infants Aged <18 Months: Results From a Nationwide Surveillance in Nigeria.

PubMed

Inzaule, Seth C; Osi, Samuels J; Akinbiyi, Gbenga; Emeka, Asadu; Khamofu, Hadiza; Mpazanje, Rex; Ilesanmi, Oluwafunke; Ndembi, Nicaise; Odafe, Solomon; Sigaloff, Kim C E; Rinke de Wit, Tobias F; Akanmu, Sulaimon

2018-01-01

WHO recommends protease-inhibitor-based first-line regimen in infants because of risk of drug resistance from failed prophylaxis used in prevention of mother-to-child transmission (PMTCT). However, cost and logistics impede implementation in sub-Saharan Africa, and >75% of children still receive nonnucleoside reverse transcriptase inhibitor-based regimen (NNRTI) used in PMTCT. We assessed the national pretreatment drug resistance prevalence of HIV-infected children aged <18 months in Nigeria, using WHO-recommended HIV drug resistance surveillance protocol. We used remnant dried blood spots collected between June 2014 and July 2015 from 15 early infant diagnosis facilities spread across all the 6 geopolitical regions of Nigeria. Sampling was through a probability proportional-to-size approach. HIV drug resistance was determined by population-based sequencing. Overall, in 48% of infants (205 of 430) drug resistance mutations (DRM) were detected, conferring resistance to predominantly NNRTIs (45%). NRTI and multiclass NRTI/NNRTI resistance were present at 22% and 20%, respectively, while resistance to protease inhibitors was at 2%. Among 204 infants with exposure to drugs for PMTCT, 57% had DRMs, conferring NNRTI resistance in 54% and multiclass NRTI/NNRTI resistance in 29%. DRMs were also detected in 34% of 132 PMTCT unexposed infants. A high frequency of PDR, mainly NNRTI-associated, was observed in a nationwide surveillance among newly diagnosed HIV-infected children in Nigeria. PDR prevalence was equally high in PMTCT-unexposed infants. Our results support the use of protease inhibitor-based first-line regimens in HIV-infected young children regardless of PMTCT history and underscore the need to accelerate implementation of the newly disseminated guideline in Nigeria.

Development and use of a population based injury surveillance system: the All Wales Injury Surveillance System (AWISS)

PubMed Central

Lyons, R; Jones, S; Kemp, A; Sibert, J; Shepherd, J; Richmond, P; Bartlett, C; Palmer, S

2002-01-01

This report details the development and use of a population based emergency room surveillance system in the UK. Despite some difficulties in accessing high quality data the system has stimulated a considerable number of research and intervention projects. While surveillance systems with high quality data collection and coding parameters remain the gold standard, imperfect systems, particularly if population based, can play a substantial part in stimulating injury prevention initiatives. PMID:11928983

32 CFR 637.20 - Security surveillance systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Security surveillance systems. 637.20 Section 637... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.20 Security surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

32 CFR 637.20 - Security surveillance systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Security surveillance systems. 637.20 Section 637.20 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

32 CFR 637.20 - Security surveillance systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Security surveillance systems. 637.20 Section 637.20 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

32 CFR 637.20 - Security surveillance systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Security surveillance systems. 637.20 Section 637.20 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

32 CFR 637.20 - Security surveillance systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Security surveillance systems. 637.20 Section 637.20 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

The development of an evaluation framework for injury surveillance systems

PubMed Central

Mitchell, Rebecca J; Williamson, Ann M; O'Connor, Rod

2009-01-01

Background Access to good quality information from injury surveillance is essential to develop and monitor injury prevention activities. To determine if information obtained from surveillance is of high quality, the limitations and strengths of a surveillance system are often examined. Guidelines have been developed to assist in evaluating certain types of surveillance systems. However, to date, no standard guidelines have been developed to specifically evaluate an injury surveillance system. The aim of this research is to develop a framework to guide the evaluation of injury surveillance systems. Methods The development of an Evaluation Framework for Injury Surveillance Systems (EFISS) involved a four stage process. First, a literature review was conducted to identify an initial set of characteristics that were recognised as important and/or had been recommended to be assessed in an evaluation of a surveillance system. Second, this set of characteristics was assessed using SMART criteria. Third, those surviving were presented to an expert panel using a two round modified-Delphi study to gain an alternative perspective on characteristic definitions, practicality of assessment, and characteristic importance. Finally, a rating system was created for the EFISS characteristics. Results The resulting EFISS consisted of 18 characteristics that assess three areas of an injury surveillance system – five characteristics assess data quality, nine characteristics assess the system's operation, and four characteristics assess the practical capability of an injury surveillance system. A rating system assesses the performance of each characteristic. Conclusion The development of the EFISS builds upon existing evaluation guidelines for surveillance systems and provides a framework tailored to evaluate an injury surveillance system. Ultimately, information obtained through an evaluation of an injury data collection using the EFISS would be useful for agencies to recommend how a

47 CFR 15.511 - Technical requirements for surveillance systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Technical requirements for surveillance systems... DEVICES Ultra-Wideband Operation § 15.511 Technical requirements for surveillance systems. (a) The UWB... surveillance systems operated by law enforcement, fire or emergency rescue organizations or by manufacturers...

47 CFR 15.511 - Technical requirements for surveillance systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Technical requirements for surveillance systems... DEVICES Ultra-Wideband Operation § 15.511 Technical requirements for surveillance systems. (a) The UWB... surveillance systems operated by law enforcement, fire or emergency rescue organizations or by manufacturers...

47 CFR 15.511 - Technical requirements for surveillance systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Technical requirements for surveillance systems... DEVICES Ultra-Wideband Operation § 15.511 Technical requirements for surveillance systems. (a) The UWB... surveillance systems operated by law enforcement, fire or emergency rescue organizations or by manufacturers...

47 CFR 15.511 - Technical requirements for surveillance systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Technical requirements for surveillance systems... DEVICES Ultra-Wideband Operation § 15.511 Technical requirements for surveillance systems. (a) The UWB... surveillance systems operated by law enforcement, fire or emergency rescue organizations or by manufacturers...

47 CFR 15.511 - Technical requirements for surveillance systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Technical requirements for surveillance systems... DEVICES Ultra-Wideband Operation § 15.511 Technical requirements for surveillance systems. (a) The UWB... surveillance systems operated by law enforcement, fire or emergency rescue organizations or by manufacturers...

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

PubMed

Maher, Dermot

2010-07-05

The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in north west England

PubMed Central

Cook, Penny A; Downing, Jennifer; Wheater, C Philip; Bellis, Mark A; Tocque, Karen; Syed, Qutub; Phillips-Howard, Penelope A

2009-01-01

Background Patient choice and access to health care is compromised by many barriers including travel distance. Individuals with the human immunodeficiency virus (HIV) can seek free specialist care in Britain, without a referral, providing flexible access to care services. Willingness to travel beyond local services for preferred care has funding and service implications. Data from an enhanced HIV surveillance system were used to explore geodemographic and clinical factors associated with accessing treatment services. Methods We extracted data on the location, type and frequency of care services utilized by HIV positive persons (n = 3983) accessing treatment in north west England between January 1st 2005 and June 30th 2006. Individuals were allocated a deprivation score and grouped by urban/rural residence, and distance to care services was calculated. Analysis identified independent predictors of distance travelled (general linear modelling) and, for those bypassing their nearest clinic, the probability of accessing a specialist service (logistic regression, SPSS ver 14). Inter-relationships between variables and distance travelled were visualised using detrended correspondence analysis (PC-ORD ver 4.1). Results HIV infected persons travelled an average of 4.8 km (95% confidence intervals (CI) 4.6–4.9) per trip and had on average 6 visits (95% CI 5.9–6.2) annually for care. Longer trips were made by males (4.8 km vs 4.5 km), white people (6.2 km), the young (>15 years, 6.8 km) and elderly (60+ years, 6.3 km), those on multiple therapy (5.3 km vs 4.0 km), and the more affluent living in rural areas (16.1 km, P < 0.05). Half the individuals bypassed their nearest clinic to visit a more distant facility, and this was associated with being aged under 20 years, multiple therapy, being a male infected by sex between men, relative wealth, and living in rural areas (P < 0.05). Of those bypassing local facilities, poorer people were more likely to access a specialist

Secure Video Surveillance System (SVSS) for unannounced safeguards inspections.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Galdoz, Erwin G.; Pinkalla, Mark

2010-09-01

The Secure Video Surveillance System (SVSS) is a collaborative effort between the U.S. Department of Energy (DOE), Sandia National Laboratories (SNL), and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The joint project addresses specific requirements of redundant surveillance systems installed in two South American nuclear facilities as a tool to support unannounced inspections conducted by ABACC and the International Atomic Energy Agency (IAEA). The surveillance covers the critical time (as much as a few hours) between the notification of an inspection and the access of inspectors to the location in facility where surveillance equipment is installed.more » ABACC and the IAEA currently use the EURATOM Multiple Optical Surveillance System (EMOSS). This outdated system is no longer available or supported by the manufacturer. The current EMOSS system has met the project objective; however, the lack of available replacement parts and system support has made this system unsustainable and has increased the risk of an inoperable system. A new system that utilizes current technology and is maintainable is required to replace the aging EMOSS system. ABACC intends to replace one of the existing ABACC EMOSS systems by the Secure Video Surveillance System. SVSS utilizes commercial off-the shelf (COTS) technologies for all individual components. Sandia National Laboratories supported the system design for SVSS to meet Safeguards requirements, i.e. tamper indication, data authentication, etc. The SVSS consists of two video surveillance cameras linked securely to a data collection unit. The collection unit is capable of retaining historical surveillance data for at least three hours with picture intervals as short as 1sec. Images in .jpg format are available to inspectors using various software review tools. SNL has delivered two SVSS systems for test and evaluation at the ABACC Safeguards Laboratory. An additional 'proto-type' system

Mass HIV Treatment and Sex Disparities in Life Expectancy: Demographic Surveillance in Rural South Africa

PubMed Central

Bor, Jacob; Rosen, Sydney; Chimbindi, Natsayi; Haber, Noah; Herbst, Kobus; Mutevedzi, Tinofa; Tanser, Frank; Pillay, Deenan; Bärnighausen, Till

2015-01-01

Background Women have better patient outcomes in HIV care and treatment than men in sub-Saharan Africa. We assessed—at the population level—whether and to what extent mass HIV treatment is associated with changes in sex disparities in adult life expectancy, a summary metric of survival capturing mortality across the full cascade of HIV care. We also determined sex-specific trends in HIV mortality and the distribution of HIV-related deaths in men and women prior to and at each stage of the clinical cascade. Methods and Findings Data were collected on all deaths occurring from 2001 to 2011 in a large population-based surveillance cohort (52,964 women and 45,688 men, ages 15 y and older) in rural KwaZulu-Natal, South Africa. Cause of death was ascertained by verbal autopsy (93% response rate). Demographic data were linked at the individual level to clinical records from the public sector HIV treatment and care program that serves the region. Annual rates of HIV-related mortality were assessed for men and women separately, and female-to-male rate ratios were estimated in exponential hazard models. Sex-specific trends in adult life expectancy and HIV-cause-deleted adult life expectancy were calculated. The proportions of HIV deaths that accrued to men and women at different stages in the HIV cascade of care were estimated annually. Following the beginning of HIV treatment scale-up in 2004, HIV mortality declined among both men and women. Female adult life expectancy increased from 51.3 y (95% CI 49.7, 52.8) in 2003 to 64.5 y (95% CI 62.7, 66.4) in 2011, a gain of 13.2 y. Male adult life expectancy increased from 46.9 y (95% CI 45.6, 48.2) in 2003 to 55.9 y (95% CI 54.3, 57.5) in 2011, a gain of 9.0 y. The gap between female and male adult life expectancy doubled, from 4.4 y in 2003 to 8.6 y in 2011, a difference of 4.3 y (95% CI 0.9, 7.6). For women, HIV mortality declined from 1.60 deaths per 100 person-years (95% CI 1.46, 1.75) in 2003 to 0.56 per 100 person

Comparison of demographic and behavioral characteristics of men who have sex with men by enrollment venue type in the National HIV Behavioral Surveillance System.

PubMed

Voetsch, Andrew C; Lansky, Amy; Drake, Amy J; MacKellar, Duncan; Bingham, Trista A; Oster, Alexandra M; Sullivan, Patrick S

2012-03-01

During 2003-2005, the National HIV Behavioral Surveillance System (NHBS) enrolled men who have sex with men (MSM) from 12 different venue types in 15 metropolitan areas in the United States. Our goal was to examine whether limiting NHBS enrollment venues to gay bars and dance clubs could increase efficiency without changing the overall results and conclusions. We used logistic regression analysis to compare the demographic characteristics and reported HIV risk behaviors among MSM enrolled in gay bars and dance clubs with those enrolled in sex venues and those enrolled in other venues. Of the 11,471 eligible men included in the analysis, 6419 (56%) were enrolled at bars and clubs, 481 (4%) at sex venues, and 4571 (40%) at other venues. Compared with men enrolled at bars and clubs, men enrolled at sex venues were more likely to be older, of nonwhite race/ethnicity, bisexual, infrequent gay venue attendees, and to have 10 or more male sex partners in the past 12 months. Men enrolled at other venues were more likely to be older and less likely to use noninjecting drugs in the past 12 months. The absolute differences in these characteristics between men enrolled in bars and clubs and those enrolled in comparison venue categories were small in most instances. Although the differences in characteristics by venue category were not large in magnitude, there was evidence that restricting NHBS enrollment to bars and clubs would affect national estimates of behavioral risk factors among MSM.

Analysis of MLS Based Surveillance System (MLSS) Concepts

DOT National Transportation Integrated Search

1989-04-01

This report examines a number of surveillance system concepts to support safe independent runway approaches and converging runways under weather conditons. All surveillance conepts are based on the use of MLS signals. The resultin surveillance is ava...

Wallops Ship Surveillance System

NASA Technical Reports Server (NTRS)

Smith, Donna C.

2011-01-01

Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

Location-based HIV behavioural surveillance among MSM in Auckland, New Zealand 2002-2011: condom use stable and more HIV testing.

PubMed

Saxton, Peter J W; Dickson, Nigel P; Hughes, Anthony J

2014-03-01

Over the last decade, annual HIV diagnoses among men who have sex with men (MSM) in New Zealand increased, then stabilised in 2006 and have not increased further. The aim was to examine trends in behaviours in order to better understand this pattern and inform community-based prevention. From 2002 to 2011, we conducted five repeat cross-sectional behavioural surveillance surveys among MSM at community locations in Auckland (fair day, gay bars, sex-on-site venues; n=6091). Participation was anonymous and self-completed. Recruitment methods were consistent at each round. Overall, the samples became more ethnically diverse and less gay community attached over time. Condom use during anal intercourse was stable across three partnering contexts (casual, current regular fuckbuddy, current regular boyfriend), with a drop among casual contacts in 2011 only. In the 6 months prior to surveys, there was a gradual decline over time in the proportion reporting >20 male partners, an increase in acquiring partners from the internet and increases in engagement in anal intercourse in some partnering contexts. HIV testing in the 12 months prior to surveys rose from 35.1% in 2002 to 50.4% in 2011, mostly from 2008. This first indepth examination of trends in HIV-related behaviours among five consecutive large and diverse samples of MSM in New Zealand does not suggest condom use is declining. However, subtle changes in sexual networks and partnering may be altering the epidemic determinants in this population and increasing exposure.

The Emerging HIV Epidemic on the Mexico-US Border: An International Case Study Characterizing the Role of Epidemiology in Surveillance and Response

PubMed Central

Strathdee, Steffanie A.; Magis-Rodriguez, Carlos; Mays, Vickie M.; Jimenez, Richard; Patterson, Thomas L.

2012-01-01

Purpose HIV/AIDS surveillance data are critical for monitoring epidemic trends, but can mask dynamic sub-epidemics, especially in vulnerable populations that under-utilize HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDU) and female sex workers (FSWs) in two northern Mexico-US Border States that identified an emerging HIV epidemic and generated a policy response. Methods We draw from quantitative and qualitative cross-sectional and prospective epidemiologic studies and behavioral intervention studies among IDUs and FSWs in Tijuana, Baja California and Ciudad Juarez, Chihuahua. Results Recognition that the HIV epidemic on Mexico’s northern border was already well established in subgroups where it had been presumed to be insignificant was met with calls for action and enhanced prevention efforts from researchers, NGOs and policy makers. Conclusions Successful policies and program outcomes included expansion of needle exchange programs, a nation-wide mobile HIV prevention program targeting marginalized populations, a successful funding bid from the Global Fund for HIV, TB and Malaria to scale up targeted HIV prevention programs and the establishment of binational training programs on prevention of HIV and substance use. We discuss how epidemiologic data informed HIV prevention policies and suggest how other countries may learn from Mexico’s experience. PMID:22626001

Congestion information surveillance system

DOT National Transportation Integrated Search

1992-10-14

This document advances a proposal to implement a Congestion Information Surveillance System (CISS)for the Albuquerque metropolitan area. The CISS will offer agencies in the region responsible for transportation and air quality management a new capabi...

Surveillance Systems to Track and Evaluate Obesity Prevention Efforts.

PubMed

Hoelscher, Deanna M; Ranjit, Nalini; Pérez, Adriana

2017-03-20

To address the obesity epidemic, the public health community must develop surveillance systems that capture data at levels through which obesity prevention efforts are conducted. Current systems assess body mass index (BMI), diet, and physical activity behaviors at the individual level, but environmental and policy-related data are often lacking. The goal of this review is to describe US surveillance systems that evaluate obesity prevention efforts within the context of international trends in obesity monitoring, to identify potential data gaps, and to present recommendations to improve the evaluation of population-level initiatives. Our recommendations include adding environmental and policy measures to surveillance efforts with a focus on addressing underserved populations, harmonizing existing surveillance systems, including more sensitive measures of obesity outcomes, and developing a knowledgeable workforce. In addition, the widespread use of electronic health records and new technologies that allow self-quantification of behaviors offers opportunities for innovative surveillance methods.

Electronic integrated disease surveillance system and pathogen asset control system.

PubMed

Wahl, Tom G; Burdakov, Aleksey V; Oukharov, Andrey O; Zhilokov, Azamat K

2012-06-20

Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO) data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS) has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP) sponsored by the US Defense Threat Reduction Agency (DTRA).

[Study on the characteristics of serology and sexual behavior among drug users at the HIV sentinel surveillance sites in 2012].

PubMed

Ge, Lin; Cui, Yan; Wang, Lu; Li, Dongmin; Guo, Wei; Ding, Zhengwei; Wang, Lan

2014-02-01

To analyze the serological results and sexual behavior among different types of drug users (DUS) at the HIV sentinel surveillance sites. Sentinel surveillance programs were conducted between April and June annually. DUS were those involved in custodes, living at the communities and those attending the methadone maintenance treatment clinics but with positive urine tests one month before blood sampling collected and questionnaire survey started. 116 279 drug abusers were included in the analysis. The prevalence rates of HIV, Syphilis and HCV among traditional drug (heroin, etc.)users were 5.0%, 4.4% and 49.4%, while the prevalence rates of new narcotic (meth, etc.) users were 0.5%, 4.6%, 15.2%, respectively. The prevalence rates of HIV, syphilis among traditional drug uses were higher than the new narcotic users (P < 0.01). The proportion of sexual behavior in last month and the proportion of sexual behavior with casual and commercial sexual partners were 46.3%, 87.2% and 28.1% among the new narcotic users, respectively, which were higher than those among traditional drug users (40.7% , 82.8% and 22.2%). The proportion of using condom in last sexual contact with casual sexual partner was 33.3% among the new narcotic users which was less than traditional drug users (36.2%). The proportion of condom use in the last commercial sexual contact was 65.1% which was higher than those traditional drug users (62.9%). The proportion of never using condom with casual and commercial sexual partners in the past year was 43.2% and 19.0% among the traditional drug users, which were higher than those among new narcotic users (41.3%, 15.3%). Compared with the traditional drug abusers, the sexual behavior of new narcotic users seemed more active, less engaging in condom use but with higher risk of HIV transmission through sexual contact.

Behavioural surveillance: the value of national coordination

PubMed Central

McGarrigle, C; Fenton, K; Gill, O; Hughes, G; Morgan, D; Evans, B

2002-01-01

Behavioural surveillance programmes have enabled the description of population patterns of risk behaviours for STI and HIV transmission and aid in the understanding of how epidemics of STI are generated. They have been instrumental in helping to refine public health interventions and inform the targeting of sexual health promotion and disease control strategies. The formalisation and coordination of behavioural surveillance in England and Wales could optimise our ability to measure the impact of interventions and health promotion strategies on behaviour. This will be particularly useful for monitoring the progress towards specific disease control targets set in the Department of Health's new Sexual Health and HIV Strategy. PMID:12473798

Mobile phone-based syndromic surveillance system, Papua New Guinea.

PubMed

Rosewell, Alexander; Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B; Ray, Pradeep; MacIntyre, C Raina

2013-11-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone-based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance.

Information Systems to Support Surveillance for Malaria Elimination

PubMed Central

Ohrt, Colin; Roberts, Kathryn W.; Sturrock, Hugh J. W.; Wegbreit, Jennifer; Lee, Bruce Y.; Gosling, Roly D.

2015-01-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. PMID:26013378

GLOBAL EMERGING INFECTIONS SURVEILLANCE AND RESPONSE SYSTEM

EPA Science Inventory

Department of Defense (DoD) Gonococcal Isolate Surveillance Project (GISP). The DoD Global Emerging Infections Surveillance and Response System (DoD-GEIS) partners with the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) in the global surv...

Challenges Presented by Re-Emerging Sexually Transmitted Infections in HIV Positive Men who have Sex with Men: An Observational Study of Lymphogranuloma Venereum in the UK.

PubMed

Rönn, Minttu; Hughes, Gwenda; Simms, Ian; Ison, Cathy; Alexander, Sarah; White, Peter J; Ward, Helen

2014-08-01

United Kingdom has reported the largest documented outbreak of lymphogranuloma venereum (LGV), a re-emerging sexually transmitted infection (STI) which is primarily seen in HIV-positive men who have sex with men (MSM). A diagnostic service was established in response to the outbreak linked to a voluntary LGV Enhanced Surveillance system. We examined the performance of this novel surveillance system to identify utility in tracking a re-emerging infection. We described laboratory data on samples and surveillance data from case reports for LGV from 2004-2010. We performed a cross-sectional analysis comparing clinical and behavioural characteristics of HIV-positive and HIV-negative/unknown LGV cases diagnosed in MSM using multivariable logistic regression models with generalised estimating equations to control for repeat infections. LGV Surveillance data were available for 87% (1,370/1,581) of LGV cases (after de-duplication). There were 1,342 episodes in 1,281 MSM, most of whom were known to be HIV-positive (1,028/1,281, 80.2%,). HIV-positive men reported a shorter duration of symptoms (aOR 0.5; 95%CI 0.3, 0.8 for reporting more than a week compared to a week or less) in comparison to HIV-negative/unknown MSM, and were more likely to report unprotected receptive anal intercourse (aOR 2.7; 95% CI 1.3, 5.8). The surveillance identified the population at greater risk of infection based on higher levels of risk behaviour in HIV-positive LGV cases. However, there was diagnostic bias towards HIV-positive LGV cases who presented with a shorter duration of symptoms when compared to HIV-negative/unknown LGV cases.

Challenges Presented by Re-Emerging Sexually Transmitted Infections in HIV Positive Men who have Sex with Men: An Observational Study of Lymphogranuloma Venereum in the UK

PubMed Central

Rönn, Minttu; Hughes, Gwenda; Simms, Ian; Ison, Cathy; Alexander, Sarah; White, Peter J; Ward, Helen

2015-01-01

Background United Kingdom has reported the largest documented outbreak of lymphogranuloma venereum (LGV), a re-emerging sexually transmitted infection (STI) which is primarily seen in HIV-positive men who have sex with men (MSM). A diagnostic service was established in response to the outbreak linked to a voluntary LGV Enhanced Surveillance system. We examined the performance of this novel surveillance system to identify utility in tracking a re-emerging infection. Methods We described laboratory data on samples and surveillance data from case reports for LGV from 2004-2010. We performed a cross-sectional analysis comparing clinical and behavioural characteristics of HIV-positive and HIV-negative/unknown LGV cases diagnosed in MSM using multivariable logistic regression models with generalised estimating equations to control for repeat infections. Results LGV Surveillance data were available for 87% (1,370/1,581) of LGV cases (after de-duplication). There were 1,342 episodes in 1,281 MSM, most of whom were known to be HIV-positive (1,028/1,281, 80.2%,). HIV-positive men reported a shorter duration of symptoms (aOR 0.5; 95%CI 0.3, 0.8 for reporting more than a week compared to a week or less) in comparison to HIV-negative/unknown MSM, and were more likely to report unprotected receptive anal intercourse (aOR 2.7; 95% CI 1.3, 5.8). Conclusion The surveillance identified the population at greater risk of infection based on higher levels of risk behaviour in HIV-positive LGV cases. However, there was diagnostic bias towards HIV-positive LGV cases who presented with a shorter duration of symptoms when compared to HIV-negative/unknown LGV cases. PMID:26301124

Self tuning system for industrial surveillance

DOEpatents

Stephan, Wegerich W; Jarman, Kristin K.; Gross, Kenneth C.

2000-01-01

A method and system for automatically establishing operational parameters of a statistical surveillance system. The method and system performs a frequency domain transition on time dependent data, a first Fourier composite is formed, serial correlation is removed, a series of Gaussian whiteness tests are performed along with an autocorrelation test, Fourier coefficients are stored and a second Fourier composite is formed. Pseudorandom noise is added, a Monte Carlo simulation is performed to establish SPRT missed alarm probabilities and tested with a synthesized signal. A false alarm test is then emperically evaluated and if less than a desired target value, then SPRT probabilities are used for performing surveillance.

Mobile Phone–based Syndromic Surveillance System, Papua New Guinea

PubMed Central

Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B.; Ray, Pradeep; MacIntyre, C. Raina

2013-01-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone–based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance. PMID:24188144

Profile: Agincourt health and socio-demographic surveillance system.

PubMed

Kahn, Kathleen; Collinson, Mark A; Gómez-Olivé, F Xavier; Mokoena, Obed; Twine, Rhian; Mee, Paul; Afolabi, Sulaimon A; Clark, Benjamin D; Kabudula, Chodziwadziwa W; Khosa, Audrey; Khoza, Simon; Shabangu, Mildred G; Silaule, Bernard; Tibane, Jeffrey B; Wagner, Ryan G; Garenne, Michel L; Clark, Samuel J; Tollman, Stephen M

2012-08-01

The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full 'reconciliation' of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities.

Sampling Key Populations for HIV Surveillance: Results From Eight Cross-Sectional Studies Using Respondent-Driven Sampling and Venue-Based Snowball Sampling.

PubMed

Rao, Amrita; Stahlman, Shauna; Hargreaves, James; Weir, Sharon; Edwards, Jessie; Rice, Brian; Kochelani, Duncan; Mavimbela, Mpumelelo; Baral, Stefan

2017-10-20

In using regularly collected or existing surveillance data to characterize engagement in human immunodeficiency virus (HIV) services among marginalized populations, differences in sampling methods may produce different pictures of the target population and may therefore result in different priorities for response. The objective of this study was to use existing data to evaluate the sample distribution of eight studies of female sex workers (FSW) and men who have sex with men (MSM), who were recruited using different sampling approaches in two locations within Sub-Saharan Africa: Manzini, Swaziland and Yaoundé, Cameroon. MSM and FSW participants were recruited using either respondent-driven sampling (RDS) or venue-based snowball sampling. Recruitment took place between 2011 and 2016. Participants at each study site were administered a face-to-face survey to assess sociodemographics, along with the prevalence of self-reported HIV status, frequency of HIV testing, stigma, and other HIV-related characteristics. Crude and RDS-adjusted prevalence estimates were calculated. Crude prevalence estimates from the venue-based snowball samples were compared with the overlap of the RDS-adjusted prevalence estimates, between both FSW and MSM in Cameroon and Swaziland. RDS samples tended to be younger (MSM aged 18-21 years in Swaziland: 47.6% [139/310] in RDS vs 24.3% [42/173] in Snowball, in Cameroon: 47.9% [99/306] in RDS vs 20.1% [52/259] in Snowball; FSW aged 18-21 years in Swaziland 42.5% [82/325] in RDS vs 8.0% [20/249] in Snowball; in Cameroon 15.6% [75/576] in RDS vs 8.1% [25/306] in Snowball). They were less educated (MSM: primary school completed or less in Swaziland 42.6% [109/310] in RDS vs 4.0% [7/173] in Snowball, in Cameroon 46.2% [138/306] in RDS vs 14.3% [37/259] in Snowball; FSW: primary school completed or less in Swaziland 86.6% [281/325] in RDS vs 23.9% [59/247] in Snowball, in Cameroon 87.4% [520/576] in RDS vs 77.5% [238/307] in Snowball) than the snowball

Future technologies for monitoring HIV drug resistance and cure.

PubMed

Parikh, Urvi M; McCormick, Kevin; van Zyl, Gert; Mellors, John W

2017-03-01

Sensitive, scalable and affordable assays are critically needed for monitoring the success of interventions for preventing, treating and attempting to cure HIV infection. This review evaluates current and emerging technologies that are applicable for both surveillance of HIV drug resistance (HIVDR) and characterization of HIV reservoirs that persist despite antiretroviral therapy and are obstacles to curing HIV infection. Next-generation sequencing (NGS) has the potential to be adapted into high-throughput, cost-efficient approaches for HIVDR surveillance and monitoring during continued scale-up of antiretroviral therapy and rollout of preexposure prophylaxis. Similarly, improvements in PCR and NGS are resulting in higher throughput single genome sequencing to detect intact proviruses and to characterize HIV integration sites and clonal expansions of infected cells. Current population genotyping methods for resistance monitoring are high cost and low throughput. NGS, combined with simpler sample collection and storage matrices (e.g. dried blood spots), has considerable potential to broaden global surveillance and patient monitoring for HIVDR. Recent adaptions of NGS to identify integration sites of HIV in the human genome and to characterize the integrated HIV proviruses are likely to facilitate investigations of the impact of experimental 'curative' interventions on HIV reservoirs.

Survey of Clostridium difficile infection surveillance systems in Europe, 2011.

PubMed

Kola, Axel; Wiuff, Camilla; Akerlund, Thomas; van Benthem, Birgit H; Coignard, Bruno; Lyytikäinen, Outi; Weitzel-Kage, Doris; Suetens, Carl; Wilcox, Mark H; Kuijper, Ed J; Gastmeier, Petra

2016-07-21

To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol. This article is copyright of The Authors, 2016.

Information systems to support surveillance for malaria elimination.

PubMed

Ohrt, Colin; Roberts, Kathryn W; Sturrock, Hugh J W; Wegbreit, Jennifer; Lee, Bruce Y; Gosling, Roly D

2015-07-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. © The American Society of Tropical Medicine and Hygiene.

Patterns of knowledge and condom use among population groups: results from the 2005 Ethiopian behavioral surveillance surveys on HIV.

PubMed

Kassie, Getnet M; Mariam, Damen H; Tsui, Amy O

2008-12-31

Behavioral surveys help interpret the magnitude of HIV/AIDS. We analyzed indicators of knowledge on HIV/AIDS and condom use among sub populations selected for behavioral surveillance in Ethiopia. We used 2005 HIV/AIDS behavioral data from ten target groups. These were female sex workers, defense forces, police force, pastoralists, truck drivers, intercity bus drivers, road construction workers, teachers, factory workers and people in ANC catchment areas. Data from 14,524 individuals were analyzed. The majority were males (63.6%). Overall, knowledge of the three preventive methods, misconceptions and comprehensive knowledge was 57%, 75% and 18.5%, respectively. Female sex workers and the defense force showed some behavioral change in using a condom during the most recent sexual encounter and consistently used a condom with non-regular sexual partners and paying partners. Women, pastoralists and the illiterate were less likely to use condom. Misconceptions about the transmission of HIV were high and comprehensive knowledge about HIV & AIDS was low, particularly among pastoralists. Consistent condom use and condom use during the last sexual encounter were high among both female sex workers and defense force employees, both with paying and non-regular sexual partners. This might be a positive sign, though a considerable proportion in each target group did not report using a condom during sex with non-regular partners.

Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation.

PubMed

Groseclose, Samuel L; Buckeridge, David L

2017-03-20

Surveillance is critical for improving population health. Public health surveillance systems generate information that drives action, and the data must be of sufficient quality and with a resolution and timeliness that matches objectives. In the context of scientific advances in public health surveillance, changing health care and public health environments, and rapidly evolving technologies, the aim of this article is to review public health surveillance systems. We consider their current use to increase the efficiency and effectiveness of the public health system, the role of system stakeholders, the analysis and interpretation of surveillance data, approaches to system monitoring and evaluation, and opportunities for future advances in terms of increased scientific rigor, outcomes-focused research, and health informatics.

[Post-marketing surveillance systems for psychoactive prescription drug abuse].

PubMed

Nordmann, Sandra; Frauger, Elisabeth; Pauly, Vanessa; Rouby, Frank; Mallaret, Michel; Micallef, Joëlle; Thirion, Xavier

2011-01-01

Drugs affecting the central nervous system form a unique group of products for surveillance because they could be misused, abused or diverted. Considering the characteristics of this behaviour that is often concealed, specific post-marketing surveillance systems have been developed to monitor abuse of prescription drugs in some countries. The purpose of this review is to list and to describe post-marketing surveillance systems, according their methodology, in France and in foreign countries. These programs are based on adverse effect notifications, medical or legal consequences of abuse, general or specific population-based survey, professional networks or medication databases. Some programs use simultaneously several information sources. In conclusion, the multifaceted nature, the diversity and the inventiveness of post-marketing surveillance systems reflects the complexity of the abuse issue. © 2011 Société Française de Pharmacologie et de Thérapeutique.

Sports Injury Surveillance Systems: A Review of Methods and Data Quality.

PubMed

Ekegren, Christina L; Gabbe, Belinda J; Finch, Caroline F

2016-01-01

Data from sports injury surveillance systems are a prerequisite to the development and evaluation of injury prevention strategies. This review aimed to identify ongoing sports injury surveillance systems and determine whether there are gaps in our understanding of injuries in certain sport settings. A secondary aim was to determine which of the included surveillance systems have evaluated the quality of their data, a key factor in determining their usefulness. A systematic search was carried out to identify (1) publications presenting methodological details of sports injury surveillance systems within clubs and organisations; and (2) publications describing quality evaluations and the quality of data from these systems. Data extracted included methodological details of the surveillance systems, methods used to evaluate data quality, and results of these evaluations. Following literature search and review, a total of 15 sports injury surveillance systems were identified. Data relevant to each aim were summarised descriptively. Most systems were found to exist within professional and elite sports. Publications concerning data quality were identified for seven (47%) systems. Validation of system data through comparison with alternate sources has been undertaken for only four systems (27%). This review identified a shortage of ongoing injury surveillance data from amateur and community sport settings and limited information about the quality of data in professional and elite settings. More surveillance systems are needed across a range of sport settings, as are standards for data quality reporting. These efforts will enable better monitoring of sports injury trends and the development of sports safety strategies.

75 FR 81512 - Airworthiness Directives; Various Aviation Communication & Surveillance Systems (ACSS) Traffic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) Units AGENCY... & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) units during a flight test over... applies to Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance...

Evaluating a surveillance system: live-bird market surveillance for highly pathogenic avian influenza, a case study.

PubMed

Waziri, Ndadilnasiya Endie; Nguku, Patrick; Olayinka, Adebola; Ajayi, Ike; Kabir, Junaidu; Okolocha, Emmanuel; Tseggai, Tesfai; Joannis, Tony; Okewole, Phillip; Kumbish, Peterside; Ahmed, Mohammed; Lombin, Lami; Nsubuga, Peter

2014-01-01

Highly pathogenic avian influenza H5N1 was first reported in poultry in Nigeria in February 2006. The only human case that occurred was linked to contact with poultry in a live bird market (LBM). LBM surveillance was instituted to assess the degree of threat of human exposure to H5N1. The key indicator was detection of H5N1 in LBMs. We evaluated the surveillance system to assess its operations and attributes. We used the US Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems. We reviewed and analyzed passive surveillance data for HPAI (January 2006-March 2009) from the Avian Influenza National Reference Laboratory, and live bird market surveillance data from the Food and Agriculture Organization of the United Nations, Nigeria. We interviewed key stakeholders and reviewed reports of live bird market surveillance to obtain additional information on the operations of the system. We assessed the key system attributes. A total of 299 cases occurred in 25 (72%) states and the Federal Capital Territory (FCT). The system detected HPAI H5N1 virus in 7 (9.5%) LBMs; 2 (29%) of which were from 2 (18.2%) states with no previous case. A total of 17,852 (91.5%) of samples arrived at the laboratory within 24 hours but laboratory analysis took over 7 days. The sensitivity and positive predictive value (PPV) were 15.4% and 66.7% respectively. The system is useful, flexible, complex and not timely, but appears to be meeting its objectives. The isolation of HPAI H5N1 virus in some of these markets is an indication that the markets are possible reservoirs of the virus in Nigeria. We recommend that the Federal Government of Nigeria should dedicate more funds for surveillance for HPAI as this will aid early warning and reduce the risk of a pandemic.

Accounting for nonsampling error in estimates of HIV epidemic trends from antenatal clinic sentinel surveillance

PubMed Central

Eaton, Jeffrey W.; Bao, Le

2017-01-01

Objectives The aim of the study was to propose and demonstrate an approach to allow additional nonsampling uncertainty about HIV prevalence measured at antenatal clinic sentinel surveillance (ANC-SS) in model-based inferences about trends in HIV incidence and prevalence. Design Mathematical model fitted to surveillance data with Bayesian inference. Methods We introduce a variance inflation parameter σinfl2 that accounts for the uncertainty of nonsampling errors in ANC-SS prevalence. It is additive to the sampling error variance. Three approaches are tested for estimating σinfl2 using ANC-SS and household survey data from 40 subnational regions in nine countries in sub-Saharan, as defined in UNAIDS 2016 estimates. Methods were compared using in-sample fit and out-of-sample prediction of ANC-SS data, fit to household survey prevalence data, and the computational implications. Results Introducing the additional variance parameter σinfl2 increased the error variance around ANC-SS prevalence observations by a median of 2.7 times (interquartile range 1.9–3.8). Using only sampling error in ANC-SS prevalence ( σinfl2=0), coverage of 95% prediction intervals was 69% in out-of-sample prediction tests. This increased to 90% after introducing the additional variance parameter σinfl2. The revised probabilistic model improved model fit to household survey prevalence and increased epidemic uncertainty intervals most during the early epidemic period before 2005. Estimating σinfl2 did not increase the computational cost of model fitting. Conclusions: We recommend estimating nonsampling error in ANC-SS as an additional parameter in Bayesian inference using the Estimation and Projection Package model. This approach may prove useful for incorporating other data sources such as routine prevalence from Prevention of mother-to-child transmission testing into future epidemic estimates. PMID:28296801

Youth Risk Behavior Surveillance System

MedlinePlus

... commit" type="submit" value="Submit" /> Youth Risk Behavior Surveillance System (YRBSS) Recommend on Facebook Tweet Share ... No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO (800-232- ...

HIV and sexually transmitted infection-related risks among female sex workers in Mongolia: second-generation surveillance survey, 2011-2012.

PubMed

Munkhbaatar, Sergelen; Aumakhan, Bulbul; Jantsansengee, Baigalmaa; Azyei, Iliza; Sanjaajamts, Zolzaya; Badrakh, Jugderjav; Sovd, Tugsdelger; Stromdahl, Susanne; Baral, Stefan; Amindavaa, Oyunbileg

2014-09-01

Surveillance studies among female sex workers (FSWs) in Mongolia have found no HIV but high rates of syphilis, ranging from 10.7% in 2002 to 20.8% in 2007. To determine the current prevalence of HIV and syphilis among FSWs, and to identify syphilis risk factors. 761 FSWs were recruited by time-location sampling between 2 January and 29 March 2012 in Ulaanbaatar city, Darkhan-Uul, Orkhon, Khuvsgul and Dornod provinces in Mongolia. Participants were administered an anonymous structured survey. Blood samples were tested for HIV and syphilis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with syphilis. The mean age of participants was 31 (median 30, interquartile range 24-38). HIV knowledge was modest: 41.3% correctly answered all questions. Consistent condom use with clients was reported by 49.1% of participants and exposure to HIV prevention programmes by 50.1%. Although no cases of HIV were found, syphilis prevalence was -27.8% (95% CI 24.3% to 31.7%). In multivariate analyses, variables associated with syphilis were younger age (age >30 years, OR=0.96, 95% CI 0.92 to 0.99) and occurrence of genital ulcer (OR=2.24, 95% CI 1.17 to 4.28). A syphilis epidemic continues to grow among FSWs in Mongolia. These women are at high risk of HIV transmission if introduced into their sexual networks. With the increase in migration of mining workers in Mongolia, introduction of HIV may be imminent. Efforts to intensify treatment and prevention programmes among FSWs are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Development concerns for satellite-based air traffic control surveillance systems

NASA Technical Reports Server (NTRS)

Mcdonald, K. D.

1985-01-01

Preliminary results of an investigation directed toward the configuration of a practical system design which can form the baseline for assessing the applications and value of a satellite based air traffic surveillance system for future use in the National Airspace System (NAS) are described. This work initially studied the characteristics and capabilities of a satellite configuration which would operate compatibly with the signal structure and avionics of the next generation air traffic control secondary surveillance radar system, the Mode S system. A compatible satellite surveillance system concept is described and an analysis is presented of the link budgets for the various transmission paths. From this, the satellite characteristics are established involving a large multiple feed L band antenna of approximately 50 meter aperture dimension. Trade offs involved in several of the alternative large aperture antennas considered are presented as well as the influence of various antenna configurations on the performance capabilities of the surveillance system. The features and limitations of the use of large aperture antenna systems for air traffic surveillance are discussed. Tentative results of this continuing effort are summarized with a brief description of follow on investigations involving other space based antenna systems concepts.

Disparities in Retention in HIV Care Among HIV-Infected Young Men Who Have Sex with Men in the District of Columbia, 2013.

PubMed

Morales-Alemán, Mercedes M; Opoku, Jenevieve; Murray, Ashley; Lanier, Yzette; Kharfen, Michael; Sutton, Madeline Y

2017-02-01

Among young men who have sex with men (YMSM), aged 13-24 years, Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV, accounting for 58% and 21%, respectively, of diagnoses of HIV infection in the United States. In the District of Columbia (DC), YMSM of color are also disproportionately affected by HIV. National goals are that 80% of HIV-infected persons be retained in HIV care. We analyzed DC surveillance data to examine retention among YMSM living with HIV infection in DC. We characterized correlates of retention in HIV care (≥2 clinical visits, ≥3 months apart, within 12 months of diagnosis) among YMSM in DC to inform and strengthen local HIV care efforts. We analyzed data from DC HIV surveillance system for YMSM aged 13-29 years diagnosed between 2005 and 2012 and alive in 2013. We also combined demographic and clinical variables with sociodemographic data from the U.S. American Community Survey (ACS) by census tracts. From 2005 to 2012, 1034 YMSM were diagnosed and living with HIV infection in DC; 83% were Black or Latino. Of the 1034 YMSM, 910 (88%) had census tract data available and were included in analyses (72% Black, 10% Latino, and 17% White); among the 854 (94%) linked to care, 376 (44%) were retained in care. In multivariate analyses, retention in care was less likely among 19-24 year YMSM compared with 13-18-year-old YMSM (adjusted prevalence ratios [aPR] = 0.89, 95% confidence intervals [CI] 0.80-0.99). Retention in HIV care was suboptimal for YMSM. Increased retention efforts are warranted to improve outcomes and reduce age and racial/ethnic disparities.

Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration.

PubMed

Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène; Balestre, Eric; Kouakou, Martial; Akakpo, Jocelyn; Ahouada, Carin; de Rekeneire, Nathalie; Dabis, François; Lewden, Charlotte; Minga, Albert

2015-04-09

The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities. Within the International epidemiological Database to Evaluate AIDS (IeDEA)--West Africa collaboration, we conducted a prospective, multicenter data collection that involved two facilities in Abidjan, Côte d'Ivoire and one in Cotonou, Benin. Among HIV-infected adults receiving ART, events were recorded using a standardized form. A simple case-definition of severe morbidity (death, hospitalization, fever>38°5C, Karnofsky index<70%) was used at any patient contact point. Then a physician confirmed and classified the event as WHO stage 3 or 4 according to the WHO clinical classification or as degree 3 or 4 of the ANRS scale. From December 2009 to December 2011, 978 adults (71% women, median age 39 years) presented with 1449 severe events. The main diagnoses were: non-AIDS-defining infections (33%), AIDS-defining illnesses (33%), suspected adverse drug reactions (7%), other illnesses (4%) and syndromic diagnoses (16%). The most common specific diagnoses were: malaria (25%), pneumonia (13%) and tuberculosis (8%). The diagnoses were reported as syndromic in one out of five events recorded during this study. This study highlights the ongoing importance of conventional infectious diseases among severe morbid events occurring in patients on ART in ambulatory HIV care facilities in West Africa. Meanwhile, additional studies are needed due to the undiagnosed aspect of severe morbidity in substantial proportion.

Estimates of CDC-Funded and National HIV Diagnoses: A Comparison by Demographic and HIV-related Factors.

PubMed

Krueger, Amy; Dietz, Patricia; Van Handel, Michelle; Belcher, Lisa; Johnson, Anna Satcher

2016-12-01

To determine whether CDC-funded HIV testing programs are reaching persons disproportionately affected by HIV infection. The percentage distribution for HIV testing and diagnoses by demographics and transmission risk group (diagnoses only) were calculated using 2013 data from CDC's National HIV Surveillance System and CDC's national HIV testing program data. In 2013, nearly 3.2 million CDC-funded tests were provided to persons aged 13 years and older. Among persons who received a CDC-funded test, 41.1 % were aged 20-29 years; 49.2 % were male, 46.2 % were black/African American, and 56.2 % of the tests were conducted in the South. Compared with the characteristics of all persons diagnosed with HIV in the United States in 2013, among persons diagnosed as a result of CDC-funded tests, a higher percentage were aged 20-29 years (40.3 vs 33.7 %) and black/African American (55.3 vs 46.0 %). CDC-funded HIV testing programs are reaching young people and blacks/African Americans.

HIV infection and HIV-associated behaviors among persons who inject drugs--20 cities, United States, 2012.

PubMed

Spiller, Michael W; Broz, Dita; Wejnert, Cyprian; Nerlander, Lina; Paz-Bailey, Gabriela

2015-03-20

In the United States, an estimated 7% of new diagnoses of human immunodeficiency virus (HIV) infection in 2012 were attributed to injection drug use, and an additional 3% to male-to-male sexual contact and injection drug use. To monitor HIV prevalence and behaviors associated with HIV risk and prevention among persons who inject drugs (PWID), CDC's National HIV Behavioral Surveillance (NHBS) system conducts interviews and HIV testing in selected cities. This report summarizes HIV prevalence and behaviors among PWID interviewed and tested in 20 cities in 2012. Of the 10,002 PWID tested, 11% had a positive HIV test result. Among 9,425 PWID included in the behavioral analysis, 30% receptively shared syringes, 70% had vaginal sex without a condom, 25% had heterosexual anal sex without a condom, and 5% of males had male-to-male sexual contact without a condom in the previous 12 months. Fifty-one percent of PWID included in the behavioral analysis had been tested for HIV, 25% participated in an HIV behavioral intervention, and 39% participated in substance abuse treatment in the previous 12 months. Additional efforts are needed to reduce risk behaviors and increase access to HIV testing, drug treatment, and other HIV prevention programs to further reduce HIV infections among PWID.

HIV Strategic Information in Non-European Union Countries in the World Health Organization European Region: Capacity Development Needs

PubMed Central

2017-01-01

Background Capacity building of the national HIV strategic information system is a core component of the response to the HIV epidemic as it enables understanding of the evolving nature of the epidemic, which is critical for program planning and identification of the gaps and deficiencies in HIV programs. Objective The study aims to describe the results of the assessment of the needs for further development of capacities in HIV strategic information systems in the non-European Union (EU) countries in the World Health Organization European Region (EUR). Methods Self-administered questionnaires were distributed to national AIDS programs. The first questionnaire was sent to all countries (N=18) to find out, among other issues, the priority level for strengthening a range of HIV surveillance areas and their key gaps and weaknesses. The second questionnaire was sent to 15 countries to more specifically determine capacities for the analysis of the HIV care cascade. Results Responses to the first questionnaire were received from 10 countries, whereas 13 countries responded to the second questionnaire. Areas that were most frequently marked as being of high to moderate priority for strengthening were national electronic patient monitoring systems, evaluation of HIV interventions and impact analysis, implementation science, and data analysis. Key weaknesseses were lack of electronic reporting of HIV cases, problems with timeliness and completeness of reporting in HIV cases, under-estimates of the reported number of HIV-related deaths, and limited CD4 count testing at the time of HIV diagnosis. Migrant populations, internally displaced persons, and refugees were most commonly mentioned as groups not covered by surveillance, followed by clients of sex workers and men who have sex with men. The majority of countries reported that they were able to provide the number of people diagnosed with HIV who know their HIV status, which is important for the analysis of cross

Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance

PubMed Central

Kaida, Angela; Carter, Allison; de Pokomandy, Alexandra; Patterson, Sophie; Proulx-Boucher, Karène; Nohpal, Adriana; Sereda, Paul; Colley, Guillaume; O'Brien, Nadia; Thomas-Pavanel, Jamie; Beaver, Kerrigan; Nicholson, Valerie J; Tharao, Wangari; Fernet, Mylène; Otis, Joanne; Hogg, Robert S; Loutfy, Mona

2015-01-01

Introduction Women represent nearly one-quarter of the 71,300 people living with HIV in Canada. Within a context of widespread HIV-related stigma and discrimination and on-going risks to HIV disclosure, little is known about the influence of growing social, legal and public health surveillance of HIV on sexual activity and satisfaction of women living with HIV (WLWH). Methods We analyzed baseline cross-sectional survey data for WLWH (≥16 years, self-identifying as women) enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a multisite, longitudinal, community-based research study in British Columbia (BC), Ontario (ON) and Quebec (QC). Sexual inactivity was defined as no consensual sex (oral or penetrative) in the prior six months, excluding recently postpartum women (≤6 months). Satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women. Multivariable logistic regression analysis examined independent correlates of sexual inactivity. Results Of 1213 participants (26% BC, 50% ON, 24% QC), median age was 43 years (IQR: 35, 50). 23% identified as Aboriginal, 28% as African, Caribbean and Black, 41% as White and 8% as other ethnicities. Heterosexual orientation was reported by 87% of participants and LGBTQ by 13%. In total, 82% were currently taking antiretroviral therapy (ART), and 77% reported an undetectable viral load (VL<40 copies/mL). Overall, 49% were sexually inactive and 64% reported being satisfied with their current sex lives, including 49% of sexually inactive and 79% of sexually active women (p<0.001). Sexually inactive women had significantly higher odds of being older (AOR=1.06 per year increase; 95% CI=1.05–1.08), not being in a marital or committed relationship (AOR=4.34; 95% CI=3.13–5.88), having an annual household income below $20,000 CAD (AOR: 1.44; 95% CI=1.08–1.92), and reporting high (vs. low) HIV-related stigma (AOR=1.81; 95% CI=1.09–3.03). No independent association was

Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance.

PubMed

Kaida, Angela; Carter, Allison; de Pokomandy, Alexandra; Patterson, Sophie; Proulx-Boucher, Karène; Nohpal, Adriana; Sereda, Paul; Colley, Guillaume; O'Brien, Nadia; Thomas-Pavanel, Jamie; Beaver, Kerrigan; Nicholson, Valerie J; Tharao, Wangari; Fernet, Mylène; Otis, Joanne; Hogg, Robert S; Loutfy, Mona

2015-01-01

Women represent nearly one-quarter of the 71,300 people living with HIV in Canada. Within a context of widespread HIV-related stigma and discrimination and on-going risks to HIV disclosure, little is known about the influence of growing social, legal and public health surveillance of HIV on sexual activity and satisfaction of women living with HIV (WLWH). We analyzed baseline cross-sectional survey data for WLWH (≥16 years, self-identifying as women) enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a multisite, longitudinal, community-based research study in British Columbia (BC), Ontario (ON) and Quebec (QC). Sexual inactivity was defined as no consensual sex (oral or penetrative) in the prior six months, excluding recently postpartum women (≤6 months). Satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women. Multivariable logistic regression analysis examined independent correlates of sexual inactivity. Of 1213 participants (26% BC, 50% ON, 24% QC), median age was 43 years (IQR: 35, 50). 23% identified as Aboriginal, 28% as African, Caribbean and Black, 41% as White and 8% as other ethnicities. Heterosexual orientation was reported by 87% of participants and LGBTQ by 13%. In total, 82% were currently taking antiretroviral therapy (ART), and 77% reported an undetectable viral load (VL<40 copies/mL). Overall, 49% were sexually inactive and 64% reported being satisfied with their current sex lives, including 49% of sexually inactive and 79% of sexually active women (p<0.001). Sexually inactive women had significantly higher odds of being older (AOR=1.06 per year increase; 95% CI=1.05-1.08), not being in a marital or committed relationship (AOR=4.34; 95% CI=3.13-5.88), having an annual household income below $20,000 CAD (AOR: 1.44; 95% CI=1.08-1.92), and reporting high (vs. low) HIV-related stigma (AOR=1.81; 95% CI=1.09-3.03). No independent association was found with ART use or undetectable

Hunters' acceptability of the surveillance system and alternative surveillance strategies for classical swine fever in wild boar - a participatory approach.

PubMed

Schulz, Katja; Calba, Clémentine; Peyre, Marisa; Staubach, Christoph; Conraths, Franz J

2016-09-06

Surveillance measures can only be effective if key players in the system accept them. Acceptability, which describes the willingness of persons to contribute, is often analyzed using participatory methods. Participatory epidemiology enables the active involvement of key players in the assessment of epidemiological issues. In the present study, we used a participatory method recently developed by CIRAD (Centre de Coopération Internationale en Recherche Agronomique pour le Développement) to evaluate the functionality and acceptability of Classical Swine Fever (CSF) surveillance in wild boar in Germany, which is highly dependent on the participation of hunters. The acceptability of alternative surveillance strategies was also analyzed. By conducting focus group discussions, potential vulnerabilities in the system were detected and feasible alternative surveillance strategies identified. Trust in the current surveillance system is high, whereas the acceptability of the operation of the system is medium. Analysis of the acceptability of alternative surveillance strategies showed how risk-based surveillance approaches can be combined to develop strategies that have sufficient support and functionality. Furthermore, some surveillance strategies were clearly rejected by the hunters. Thus, the implementation of such strategies may be difficult. Participatory methods can be used to evaluate the functionality and acceptability of existing surveillance plans for CSF among hunters and to optimize plans regarding their chances of successful implementation.

Radiological differences between HIV-positive and HIV-negative children with cholesteatoma.

PubMed

McGuire, J K; Fagan, J J; Wojno, M; Manning, K; Harris, T

2018-07-01

HIV-positive children are possibly more prone to developing cholesteatoma. Chronic inflammation of the middle ear cleft may be more common in patients with HIV and this may predispose HIV-positive children to developing cholesteatoma. There are no studies that describe the radiological morphology of the middle ear cleft in HIV-positive compared to HIV-negative children with cholesteatoma. Compare the radiological differences of the middle ear cleft in HIV-positive and HIV-negative children with cholesteatoma. A retrospective, cross-sectional, observational analytical review of patients with cholesteatoma at our institute over a 6 year period. Forty patients were included in the study, 11 of whom had bilateral cholesteatoma and therefore 51 ears were eligible for our evaluation. HIV-positive patients had smaller (p=0.02) mastoid air cell systems (MACS). Forty percent of HIV-positive patients had sclerotic mastoids, whereas the rate was 3% in HIV-negative ears (p<0.02). Eighty-two percent of the HIV-positive patients had bilateral cholesteatoma compared to 7% of the control group (p<0.02). There was no difference between the 2 groups with regards to opacification of the middle ear cleft, bony erosion of middle ear structures, Eustachian tube obstruction or soft tissue occlusion of the post-nasal space. HIV-positive paediatric patients with cholesteatoma are more likely to have smaller, sclerotic mastoids compared to HIV-negative patients. They are significantly more likely to have bilateral cholesteatoma. This may have implications in terms of surveillance of HIV-positive children, as well as, an approach to management, recurrence and follow-up. HIV infection should be flagged as a risk factor for developing cholesteatoma. Copyright © 2018. Published by Elsevier B.V.

Strengthening Routine Data Systems to Track the HIV Epidemic and Guide the Response in Sub-Saharan Africa.

PubMed

Rice, Brian; Boulle, Andrew; Baral, Stefan; Egger, Matthias; Mee, Paul; Fearon, Elizabeth; Reniers, Georges; Todd, Jim; Schwarcz, Sandra; Weir, Sharon; Rutherford, George; Hargreaves, James

2018-04-03

The global HIV response has entered a new phase with the recommendation of treating all persons living with HIV with antiretroviral therapy, and with the goals of reducing new infections and AIDS-related deaths to fewer than 500,000 by 2020. This new phase has intensive data requirements that will need to utilize routine data collected through service delivery platforms to monitor progress toward these goals. With a focus on sub-Saharan African, we present the following priorities to improve the demand, supply, and use of routine HIV data: (1) strengthening patient-level HIV data systems that support continuity of clinical care and document sentinel events; (2) leveraging data from HIV testing programs; (3) using targeting data collection in communities and among clients; and (4) building capacity and promoting a culture of HIV data quality assessment and use. When fully leveraged, routine data can efficiently provide timely information at a local level to inform action, as well as provide information at scale with wide geographic coverage to strengthen estimation efforts. ©Brian Rice, Andrew Boulle, Stefan Baral, Matthias Egger, Paul Mee, Elizabeth Fearon, Georges Reniers, Jim Todd, Sandra Schwarcz, Sharon Weir, George Rutherford, James Hargreaves. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 03.04.2018.

Establishing a cost-effective national surveillance system for Bluetongue using scenario tree modelling.

PubMed

Hadorn, Daniela C; Racloz, Vanessa; Schwermer, Heinzpeter; Stärk, Katharina D C

2009-01-01

Vector-borne diseases pose a special challenge to veterinary authorities due to complex and time-consuming surveillance programs taking into account vector habitat. Using stochastic scenario tree modelling, each possible surveillance activity of a future surveillance system can be evaluated with regard to its sensitivity and the expected cost. The overall sensitivity of various potential surveillance systems, composed of different combinations of surveillance activities, is calculated and the proposed surveillance system is optimized with respect to the considered surveillance activities, the sensitivity and the cost. The objective of this project was to use stochastic scenario tree modelling in combination with a simple cost analysis in order to develop the national surveillance system for Bluetongue in Switzerland. This surveillance system was established due to the emerging outbreak of Bluetongue virus serotype 8 (BTV-8) in Northern Europe in 2006. Based on the modelling results, it was decided to implement an improved passive clinical surveillance in cattle and sheep through campaigns in order to increase disease awareness alongside a targeted bulk milk testing strategy in 200 dairy cattle herds located in high-risk areas. The estimated median probability of detection of cases (i.e. sensitivity) of the surveillance system in this combined approach was 96.4%. The evaluation of the prospective national surveillance system predicted that passive clinical surveillance in cattle would provide the highest probability to detect BTV-8 infected animals, followed by passive clinical surveillance in sheep and bulk milk testing of 200 dairy cattle farms in high-risk areas. This approach is also applicable in other countries and to other epidemic diseases.

Profile: Agincourt Health and Socio-demographic Surveillance System

PubMed Central

Kahn, Kathleen; Collinson, Mark A; Gómez-Olivé, F Xavier; Mokoena, Obed; Twine, Rhian; Mee, Paul; Afolabi, Sulaimon A; Clark, Benjamin D; Kabudula, Chodziwadziwa W; Khosa, Audrey; Khoza, Simon; Shabangu, Mildred G; Silaule, Bernard; Tibane, Jeffrey B; Wagner, Ryan G; Garenne, Michel L; Clark, Samuel J; Tollman, Stephen M

2012-01-01

The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full ‘reconciliation’ of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities. PMID:22933647

HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults.

PubMed

Mojola, Sanyu A; Williams, Jill; Angotti, Nicole; Gómez-Olivé, F Xavier

2015-10-01

South Africa has the highest number of people living with HIV in the world (over 6 million) as well as a rapidly aging population, with 15% of the population aged 50 and over. High HIV prevalence in rural former apartheid homeland areas suggests substantial aging with HIV and acquisition of HIV at older ages. We develop a life course approach to HIV vulnerability, highlighting the rise and fall of risk and protection as people age, as well as the role of contextual density in shaping HIV vulnerability. Using this approach, we draw on an innovative multi-method data set collected within the Agincourt Health and Demographic Surveillance System in South Africa, combining survey data with 60 nested life history interviews and 9 community focus group interviews. We examine HIV risk and protective factors among adults aged 40-80, as well as how and why these factors vary among people at older ages. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Epidemic characteristics of HIV/AIDS among men who have sex with men from 2006 to 2010 in China].

PubMed

Hei, Fa-xin; Wang, Lu; Qin, Qian-qian; Wang, Lan; Guo, Wei; Li, Dong-min; Ding, Zheng-wei

2012-01-01

To analyze the epidemic characteristics of HIV/AIDS among men who have sex with men (MSM) from 2006 to 2010 in China, and to provide evidence for the development of prevention and control measures. Through the network reporting information system. The distribution of MSM transmission was analyzed. Through sentinel surveillance system from 2006 to 2010, data was gathered and analyzed for HIV/AIDS positive rates and condom use to describe the epidemic characteristics of HIV/AIDS among MSM. Data from HIV/AIDS case reporting system showed that the proportion of MSM transmission was on the rise (from 1.5% in 2006 to 10.8% in 2010), becoming the fastest growth of spreading. Compared with other routes of spreading, MSM transmission showed the following obvious characteristics: 15 to 29 years olds (54.6%), having higher culture background (senior high school graduated or above accounting for 69.8%), unmarried (64.8%), being cadres/teacher/doctor/retirees and students (accounted for 14.3% and 7.9%), with high mobility floating population (36.2%), being urban population (72.6%), having history of blood donation without payment (26.7% and 6.4%). In terms of location, they mainly lived in provinces as Beijing, Sichuan, Guangdong, Chongqing, Jiangsu, Zhejiang, Shanghai and Liaoning where economics were more developed. Data from HIV/AIDS sentinel surveillance system showed that, from 2006 to 2010, the HIV positive anti-body detection rate (median) was 3.4% among MSM in this country, much higher than among the female sex workers. Rate on condom usage (median) was 73.2%, lower than among the female sex workers. The proportion of HIV transmission among MSM was on the rapid rise from 2006 to 2010 in China. Through HIV/AIDS sentinel surveillance system, we found that the infection rate was high but the rate of condom usage was low among MSM. Factors as being 15 to 29 years olds, students and blood donors should be under major concern.

The global transmission network of HIV-1.

PubMed

Wertheim, Joel O; Leigh Brown, Andrew J; Hepler, N Lance; Mehta, Sanjay R; Richman, Douglas D; Smith, Davey M; Kosakovsky Pond, Sergei L

2014-01-15

Human immunodeficiency virus type 1 (HIV-1) is pandemic, but its contemporary global transmission network has not been characterized. A better understanding of the properties and dynamics of this network is essential for surveillance, prevention, and eventual eradication of HIV. Here, we apply a simple and computationally efficient network-based approach to all publicly available HIV polymerase sequences in the global database, revealing a contemporary picture of the spread of HIV-1 within and between countries. This approach automatically recovered well-characterized transmission clusters and extended other clusters thought to be contained within a single country across international borders. In addition, previously undescribed transmission clusters were discovered. Together, these clusters represent all known modes of HIV transmission. The extent of international linkage revealed by our comprehensive approach demonstrates the need to consider the global diversity of HIV, even when describing local epidemics. Finally, the speed of this method allows for near-real-time surveillance of the pandemic's progression.

[Problems and prospects of infectious diseases and HIV-infected military personnel register organization].

PubMed

Bolekhan, V N; Zagorodnikov, G G; Gorichnyĭ, V A; Orlova, E S; Nikolaev, P G

2014-08-01

An analysis of regulatory documents of the Ministry of Healthcare and the Ministry of Defence of the Russian Federation related to HIV/AIDS prevention was carried out. The current system of HIV/AIDS detection and registration among military and civil personnel was assessed. Problems and prospects of scientific-and-research laboratory (the register of infectious disease pathology and HIV-infected military personnel) of Scientific-and-research centre at the Kirov Military medical academy were discussed. It is proposed that the main direction of the laboratory activity will be the restoration of up-to-date records of military personnel with HIV/AIDS. This activity will provide the necessary information to responsible specialists of the Main state sanitary and epidemiological surveillance centre and the Main military medical department of the Ministry of Defence of the Russian Federation for the sanitary and epidemiological surveillance for purposeful and economically feasible management decisions in the field of military personnel infection diseases prevention.

HIV Research with Men who Have Sex with Men (MSM): Advantages and Challenges of Different Methods for Most Appropriately Targeting a Key Population.

PubMed

Gama, Ana; Martins, Maria O; Dias, Sónia

2017-01-01

The difficulty in accessing hard-to-reach populations as men who have sex with men presents a dilemma for HIV surveillance as their omission from surveillance systems leaves significant gaps in our understanding of HIV/AIDS epidemics. Several methods for recruiting difficult-to-access populations and collecting data on trends of HIV prevalence and behavioural factors for surveillance and research purposes have emerged. This paper aims to critically review different sampling approaches, from chain-referral and venue-based to respondent-driven, time-location and internet sampling methods, focusing on its main advantages and challenges for conducting HIV research among key populations, such as men who have sex with men. The benefits of using these approaches to recruit participants must be weighed against privacy concerns inherent in any social situation or health condition. Nevertheless, the methods discussed in this paper represent some of the best efforts to effectively reach most-at-risk subgroups of men who have sex with men, contributing to obtain unbiased trends of HIV prevalence and HIV-related risk behaviours among this population group.

HIV Research with Men who Have Sex with Men (MSM): Advantages and Challenges of Different Methods for Most Appropriately Targeting a Key Population

PubMed Central

Gama, Ana; Martins, Maria O.; Dias, Sónia

2017-01-01

The difficulty in accessing hard-to-reach populations as men who have sex with men presents a dilemma for HIV surveillance as their omission from surveillance systems leaves significant gaps in our understanding of HIV/AIDS epidemics. Several methods for recruiting difficult-to-access populations and collecting data on trends of HIV prevalence and behavioural factors for surveillance and research purposes have emerged. This paper aims to critically review different sampling approaches, from chain-referral and venue-based to respondent-driven, time-location and internet sampling methods, focusing on its main advantages and challenges for conducting HIV research among key populations, such as men who have sex with men. The benefits of using these approaches to recruit participants must be weighed against privacy concerns inherent in any social situation or health condition. Nevertheless, the methods discussed in this paper represent some of the best efforts to effectively reach most-at-risk subgroups of men who have sex with men, contributing to obtain unbiased trends of HIV prevalence and HIV-related risk behaviours among this population group. PMID:29546214

Achieving the Goals of the National HIV/AIDS Strategy: Declining HIV Diagnoses, Improving Clinical Outcomes, and Diminishing Racial/Ethnic Disparities in King County, WA (2004-2013).

PubMed

Golden, Matthew R; Bennett, Amy B; Dombrowski, Julia C; Buskin, Susan E

2016-05-01

The US National HIV/AIDS Strategy defines national objectives related to HIV prevention and care. The extent to which US cities are meeting those objectives is uncertain. We analyzed King County, WA, HIV surveillance data collected between 2004 and 2013. The study population included 9539 persons diagnosed as having and living with HIV infection and 3779 persons with newly diagnosed HIV infection. Between 2004 and 2013, the rate of new HIV diagnosis decreased from 18.4 to 13.2 per 100,000 residents (decline of 28%); AIDS diagnosis rates declined 42% from 12 to 7 per 100,000; and age-adjusted death rates decreased from 27 to 15 per 1000 persons living with HIV/AIDS (decline of 42%; P<0.0001 for all 3 trends). The rate of new HIV diagnosis declined 26% among men who have sex with men (MSM; P=0.0002), with the largest decline occurring in black MSM (44%). Among 8679 individuals with laboratory results reported to National HIV Surveillance System from 2006 through 2013, viral suppression (viral load<200 copies/mL) increased from 45% to 86% (P<0.0001), with all racial/ethnic groups achieving greater than 80% viral suppression in 2013. The rates of new HIV diagnosis, AIDS diagnoses, and mortality in persons living with HIV in King County, WA, have significantly declined over the last decade. These changes have occurred concurrent with a dramatic increase in HIV viral suppression and have affected diverse populations, including MSM and African American MSM. These findings demonstrate substantial local success in achieving the goals of the National HIV/AIDS Strategy.

HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.

PubMed

Streatfield, P Kim; Khan, Wasif A; Bhuiya, Abbas; Hanifi, Syed M A; Alam, Nurul; Millogo, Ourohiré; Sié, Ali; Zabré, Pascal; Rossier, Clementine; Soura, Abdramane B; Bonfoh, Bassirou; Kone, Siaka; Ngoran, Eliezer K; Utzinger, Juerg; Abera, Semaw F; Melaku, Yohannes A; Weldearegawi, Berhe; Gomez, Pierre; Jasseh, Momodou; Ansah, Patrick; Azongo, Daniel; Kondayire, Felix; Oduro, Abraham; Amu, Alberta; Gyapong, Margaret; Kwarteng, Odette; Kant, Shashi; Pandav, Chandrakant S; Rai, Sanjay K; Juvekar, Sanjay; Muralidharan, Veena; Wahab, Abdul; Wilopo, Siswanto; Bauni, Evasius; Mochamah, George; Ndila, Carolyne; Williams, Thomas N; Khagayi, Sammy; Laserson, Kayla F; Nyaguara, Amek; Van Eijk, Anna M; Ezeh, Alex; Kyobutungi, Catherine; Wamukoya, Marylene; Chihana, Menard; Crampin, Amelia; Price, Alison; Delaunay, Valérie; Diallo, Aldiouma; Douillot, Laetitia; Sokhna, Cheikh; Gómez-Olivé, F Xavier; Mee, Paul; Tollman, Stephen M; Herbst, Kobus; Mossong, Joël; Chuc, Nguyen T K; Arthur, Samuelina S; Sankoh, Osman A; Byass, Peter

2014-01-01

As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia. Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population. The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates. Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.

Estimating the population of female sex workers in two Chinese cities on the basis of the HIV/AIDS behavioural surveillance approach combined with a multiplier method

PubMed Central

Zhang, Dapeng; Lv, Fan; Wang, Liyan; Sun, Liangxian; Zhou, Jian; Su, Wenyi; Bi, Peng

2007-01-01

Objective To estimate the size of the population of female sex workers (FSWs) on the basis of the HIV/AIDS behavioural surveillance approach in two Chinese cities, using a multiplier method. Method Relevant questions were inserted into the questionnaires given to two behavioural surveillance groups—female attendees of sexually transmitted disease (STD) clinics and FSWs. The size of the FSW population was derived by multiplying the number of FSWs in selected STD clinics during the study period by the proportion of FSW population who reported having attended the selected STD clinics during the same period. Results The size of the FSW population in the urban area of Xingyi, China, was estimated to be about 2500 (95% CI 2000 to 3400). This accounted for 3.6% of the total urban adult female population. There were an estimated 17 500 FSWs in the urban area of Guiyang, China (95% CI 10 300 to 31 900) or about 3.4% of its total urban adult female population (rounded to the nearest 100). Conclusions The multiplier method could be a useful and cost‐effective approach to estimate the FSW population, especially suitable in countries where HIV behavioural surveillance has been established in high‐risk populations. PMID:17090568

Web-based infectious disease surveillance systems and public health perspectives: a systematic review.

PubMed

Choi, Jihye; Cho, Youngtae; Shim, Eunyoung; Woo, Hyekyung

2016-12-08

Emerging and re-emerging infectious diseases are a significant public health concern, and early detection and immediate response is crucial for disease control. These challenges have led to the need for new approaches and technologies to reinforce the capacity of traditional surveillance systems for detecting emerging infectious diseases. In the last few years, the availability of novel web-based data sources has contributed substantially to infectious disease surveillance. This study explores the burgeoning field of web-based infectious disease surveillance systems by examining their current status, importance, and potential challenges. A systematic review framework was applied to the search, screening, and analysis of web-based infectious disease surveillance systems. We searched PubMed, Web of Science, and Embase databases to extensively review the English literature published between 2000 and 2015. Eleven surveillance systems were chosen for evaluation according to their high frequency of application. Relevant terms, including newly coined terms, development and classification of the surveillance systems, and various characteristics associated with the systems were studied. Based on a detailed and informative review of the 11 web-based infectious disease surveillance systems, it was evident that these systems exhibited clear strengths, as compared to traditional surveillance systems, but with some limitations yet to be overcome. The major strengths of the newly emerging surveillance systems are that they are intuitive, adaptable, low-cost, and operated in real-time, all of which are necessary features of an effective public health tool. The most apparent potential challenges of the web-based systems are those of inaccurate interpretation and prediction of health status, and privacy issues, based on an individual's internet activity. Despite being in a nascent stage with further modification needed, web-based surveillance systems have evolved to complement

Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries.

PubMed

Nsubuga, Peter; Nwanyanwu, Okey; Nkengasong, John N; Mukanga, David; Trostle, Murray

2010-12-03

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening.With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention.We describe two ways that health ministries in developing countries could leverage President Obama's Global Health Initiative (GHI) to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM]) can also adapt their current health systems strengthening programs to build sustainable public health systems.

HIV after 40 in Rural South Africa1: A Life Course Approach to HIV Vulnerability among Middle Aged and Older Adults

PubMed Central

Williams, Jill; Angotti, Nicole; Gómez-Olivé, Xavier

2015-01-01

South Africa has the highest number of people living with HIV in the world (over 6 million) as well as a rapidly aging population, with 15% of the population aged 50 and over. High HIV prevalence in rural former apartheid homeland areas suggests substantial aging with HIV and acquisition of HIV at older ages. We develop a life course approach to HIV vulnerability, highlighting the rise and fall of risk and protection as people age, as well as the role of contextual density in shaping HIV vulnerability. Using this approach, we draw on an innovative multi-method data set collected within the Agincourt Health and Demographic Surveillance System in South Africa, combining survey data with 60 nested life history interviews and 9 community focus group interviews. We examine HIV risk and protective factors among adults aged 40–80, as well as how and why these vary among people at older ages. PMID:26364007

Work-Related Injury Surveillance in Vietnam: A National Reporting System Model

PubMed Central

Marucci-Wellman, Helen; Wegman, David H.; Leamon, Tom B.; Tuyet Binh, Ta Thi; Diep, Nguyen Bich; Kriebel, David

2013-01-01

Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam’s Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system. PMID:24028255

Surveillance System for Infectious Diseases of Pets, Santiago, Chile

PubMed Central

López, Javier; Abarca, Katia; Valenzuela, Berta; Lorca, Lilia; Olea, Andrea; Aguilera, Ximena

2009-01-01

Pet diseases may pose risks to human health but are rarely included in surveillance systems. A pilot surveillance system of pet infectious diseases in Santiago, Chile, found that 4 canine and 3 feline diseases accounted for 90.1% and 98.4% of notifications, respectively. Data also suggested association between poverty and pet diseases. PMID:19861073

[Sexually transmitted diseases and HIV-1 infection in Italian adolescents].

PubMed

Giuliani, M; Suligoi, B

2000-12-01

To assess the distribution of specific sexually transmitted diseases (STD), including HIV-1 infection, among Italian adolescents with an acute STD and to evaluate these individuals behavioural characteristics. The database of Italy's STD Surveillance System was used as the source of data. Data on all STD cases reported among individuals under 20 years of age were analysed. From September 1990 to December 1997, 57,046 cases of STDs were reported to the surveillance system; 1,757 (3.1%) of these were reported among adolescents, of whom 896 (51.0%) were males. The most commonly reported diseases among males were genital warts (30.7%) and non-gonococcal urethritis (18.5%); among females, the most commonly reported diseases were non-gonococcal vaginitis (39.1%) and genital warts (30.0%). Of the 555 males tested for HIV-1 antibodies, 28 (5.0%) were seropositive; of the 510 females tested, 17 (3.3%) were seropositive. The highest HIV-1 seroprevalence rates were found among intravenous drug users (IDU) (33.3% among male IDUs and 23.8% among female IDUs) and among homosexual males (17.6%). In Italy, the impact of STDs among adolescents is not negligible, though the distribution of STDs among this population group differs from the distribution among adults. Moreover, the prevalence of HIV-1 among adolescents with STDs is similar to that among adults with STDs. This study's data suggest the need to further develop STD/HIV prevention programmes that specifically target youths.

Mobile Phone–based Infectious Disease Surveillance System, Sri Lanka

PubMed Central

Sawford, Kate; Daniel, Samson L.A.; Nelson, Trisalyn A.; Stephen, Craig

2010-01-01

Because many infectious diseases are emerging in animals in low-income and middle-income countries, surveillance of animal health in these areas may be needed for forecasting disease risks to humans. We present an overview of a mobile phone–based frontline surveillance system developed and implemented in Sri Lanka. Field veterinarians reported animal health information by using mobile phones. Submissions increased steadily over 9 months, with ≈4,000 interactions between field veterinarians and reports on the animal population received by the system. Development of human resources and increased communication between local stakeholders (groups and persons whose actions are affected by emerging infectious diseases and animal health) were instrumental for successful implementation. The primary lesson learned was that mobile phone–based surveillance of animal populations is acceptable and feasible in lower-resource settings. However, any system implementation plan must consider the time needed to garner support for novel surveillance methods among users and stakeholders. PMID:20875276

Design and implementation of distributed multimedia surveillance system based on object-oriented middleware

NASA Astrophysics Data System (ADS)

Cao, Xuesong; Jiang, Ling; Hu, Ruimin

2006-10-01

Currently, the applications of surveillance system have been increasingly widespread. But there are few surveillance platforms that can meet the requirement of large-scale, cross-regional, and flexible surveillance business. In the paper, we present a distributed surveillance system platform to improve safety and security of the society. The system is constructed by an object-oriented middleware called as Internet Communications Engine (ICE). This middleware helps our platform to integrate a lot of surveillance resource of the society and accommodate diverse range of surveillance industry requirements. In the follow sections, we will describe in detail the design concepts of system and introduce traits of ICE.

HIV testing in national population-based surveys: experience from the Demographic and Health Surveys.

PubMed Central

Mishra, Vinod; Vaessen, Martin; Boerma, J. Ties; Arnold, Fred; Way, Ann; Barrere, Bernard; Cross, Anne; Hong, Rathavuth; Sangha, Jasbir

2006-01-01

OBJECTIVES: To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. METHODS: During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. RESULTS: Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. CONCLUSIONS: Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics. PMID:16878227

Next Generation Space Surveillance System-of-Systems

NASA Astrophysics Data System (ADS)

McShane, B.

2014-09-01

International economic and military dependence on space assets is pervasive and ever-growing in an environment that is now congested, contested, and competitive. There are a number of natural and man-made risks that need to be monitored and characterized to protect and preserve the space environment and the assets within it. Unfortunately, today's space surveillance network (SSN) has gaps in coverage, is not resilient, and has a growing number of objects that get lost. Risks can be efficiently and effectively mitigated, gaps closed, resiliency improved, and performance increased within a next generation space surveillance network implemented as a system-of-systems with modern information architectures and analytic techniques. This also includes consideration for the newest SSN sensors (e.g. Space Fence) which are born Net-Centric out-of-the-box and able to seamlessly interface with the JSpOC Mission System, global information grid, and future unanticipated users. Significant opportunity exists to integrate legacy, traditional, and non-traditional sensors into a larger space system-of-systems (including command and control centers) for multiple clients through low cost sustainment, modification, and modernization efforts. Clients include operations centers (e.g. JSpOC, USSTRATCOM, CANSPOC), Intelligence centers (e.g. NASIC), space surveillance sensor sites (e.g. AMOS, GEODSS), international governments (e.g. Germany, UK), space agencies (e.g. NASA), and academic institutions. Each has differing priorities, networks, data needs, timeliness, security, accuracy requirements and formats. Enabling processes and technologies include: Standardized and type accredited methods for secure connections to multiple networks, machine-to-machine interfaces for near real-time data sharing and tip-and-queue activities, common data models for analytical processing across multiple radar and optical sensor types, an efficient way to automatically translate between differing client and

EASY-HIT: HIV full-replication technology for broad discovery of multiple classes of HIV inhibitors.

PubMed

Kremb, Stephan; Helfer, Markus; Heller, Werner; Hoffmann, Dieter; Wolff, Horst; Kleinschmidt, Andrea; Cepok, Sabine; Hemmer, Bernhard; Durner, Jörg; Brack-Werner, Ruth

2010-12-01

HIV replication assays are important tools for HIV drug discovery efforts. Here, we present a full HIV replication system (EASY-HIT) for the identification and analysis of HIV inhibitors. This technology is based on adherently growing HIV-susceptible cells, with a stable fluorescent reporter gene activated by HIV Tat and Rev. A fluorescence-based assay was designed that measures HIV infection by two parameters relating to the early and the late phases of HIV replication, respectively. Validation of the assay with a panel of nine reference inhibitors yielded effective inhibitory concentrations consistent with published data and allowed discrimination between inhibitors of early and late phases of HIV replication. Finer resolution of the effects of reference drugs on different steps of HIV replication was achieved in secondary time-of-addition assays. The EASY-HIT assay yielded high Z' scores (>0.9) and signal stabilities, confirming its robustness. Screening of the LOPAC(1280) library identified 10 compounds (0.8%), of which eight were known to inhibit HIV, validating the suitability of this assay for screening applications. Studies evaluating anti-HIV activities of natural products with the EASY-HIT technology led to the identification of three novel inhibitory compounds that apparently act at different steps of HIV-1 replication. Furthermore, we demonstrate successful evaluation of plant extracts for HIV-inhibitory activities, suggesting application of this technology for the surveillance of biological extracts with anti-HIV activities. We conclude that the EASY-HIT technology is a versatile tool for the discovery and characterization of HIV inhibitors.

An estimate of the magnitude and trend of HIV/AIDS epidemic using data from the routine VCT services as an alternative data source to ANC sentinel surveillance in Addis Ababa, Ethiopia.

PubMed

Getachew, Yehenew; Gotu, Butte; Enquselassie, Fikre

2010-10-01

Since early 1980s when AIDS was first recognized, there has been uncertainty about the future trend and the ultimate dimensions of the pandemic. This uncertainty persists because of difficulties in measuring HIV incidence and prevalence with a substantial degree of precision in a given population. One of the many factors for the lack of precision is the problem of obtaining representative data sources that can be extrapolated to the general population. National and regional HIV estimates for Ethiopia are derived from ANC based HIV surveillance data. Alternative data sources have not been exhaustively explored as potential tools to monitor the trend of HIV/ AIDS epidemic in the country. To estimate the magnitude and trend of HIV/AIDS epidemic using data from the routine VCT services as an alternative data source to ANC sentinel surveillance data. The study used secondary data sources from all government, private and NGO VCT centers, of the period of 2003-2005 in Addis Ababa. For the purpose of making comparative analysis of the VCT based estimations and projections, records of all five sentinel sites in Addis Ababa for the period 1983-2003 were reviewed. Both ANC and VCT data sources showed similar and regular trends from the beginning of the HIV epidemic till the year 1995 where the ANC showed a relatively higher prevalence rates than VCT data, with a maximum difference in HIV prevalence of 1.06% in 1993. However, a higher HIV prevalence was noted for the VCT than the ANC data source for the period of 1996-2002, with a maximum difference of 1.4% in 1998, the year when both the ANC and VCT modeled HIV prevalence reached the highest peak in Addis Ababa. On the contrary, the ANC based prevalence was higher than the VCT data for the period 2004-2010, with a maximum difference of 2.2%. This study suggests that VCT based HIV prevalence data closely approximates the ANC based data. Therefore VCT data source can be valuable to complement the ANC data in monitoring the HIV

Increase coverage of HIV and AIDS services in Myanmar

PubMed Central

Williams, Brian; Baker, Daniel; Bühler, Markus; Petrie, Charles

2008-01-01

Myanmar is experiencing an HIV epidemic documented since the late 1980s. The National AIDS Programme national surveillance ante-natal clinics had already estimated in 1993 that 1.4% of pregnant women were HIV positive, and UNAIDS estimates that at end 2005 1.3% (range 0.7–2.0%) of the adult population was living with HIV. While a HIV surveillance system has been in place since 1992, the programmatic response to the epidemic has been slower to emerge although short- and medium-terms plans have been formulated since 1990. These early plans focused on the health sector, omitted key population groups at risk of HIV transmission and have not been adequately funded. The public health system more generally is severely under-funded. By the beginning of the new decade, a number of organisations had begun working on HIV and AIDS, though not yet in a formally coordinated manner. The Joint Programme on AIDS in Myanmar 2003–2005 was an attempt to deliver HIV services through a planned and agreed strategic framework. Donors established the Fund for HIV/AIDS in Myanmar (FHAM), providing a pooled mechanism for funding and significantly increasing the resources available in Myanmar. By 2006 substantial advances had been made in terms of scope and diversity of service delivery, including outreach to most at risk populations to HIV. More organisations provided more services to an increased number of people. Services ranged from the provision of HIV prevention messages via mass media and through peers from high-risk groups, to the provision of care, treatment and support for people living with HIV. However, the data also show that this scaling up has not been sufficient to reach the vast majority of people in need of HIV and AIDS services. The operating environment constrains activities, but does not, in general, prohibit them. The slow rate of service expansion can be attributed to the burdens imposed by administrative measures, broader constraints on research, debate and

Systems pharmacology augments drug safety surveillance

PubMed Central

Lorberbaum, Tal; Nasir, Mavra; Keiser, Michael J.; Vilar, Santiago; Hripcsak, George; Tatonetti, Nicholas P.

2014-01-01

Small molecule drugs are the foundation of modern medical practice yet their use is limited by the onset of unexpected and severe adverse events (AEs). Regulatory agencies rely on post-marketing surveillance to monitor safety once drugs are approved for clinical use. Despite advances in pharmacovigilance methods that address issues of confounding bias, clinical data of AEs are inherently noisy. Systems pharmacology– the integration of systems biology and chemical genomics – can illuminate drug mechanisms of action. We hypothesize that these data can improve drug safety surveillance by highlighting drugs with a mechanistic connection to the target phenotype (enriching true positives) and filtering those that do not (depleting false positives). We present an algorithm, the modular assembly of drug safety subnetworks (MADSS), to combine systems pharmacology and pharmacovigilance data and significantly improve drug safety monitoring for four clinically relevant adverse drug reactions. PMID:25670520

Descriptive review of tuberculosis surveillance systems across the circumpolar regions.

PubMed

Bourgeois, Annie-Claude; Zulz, Tammy; Soborg, Bolette; Koch, Anders

2016-01-01

Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey - representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. This review successfully establishes baseline knowledge on similarities and differences among circumpolar

Descriptive review of tuberculosis surveillance systems across the circumpolar regions

PubMed Central

Bourgeois, Annie-Claude; Zulz, Tammy; Soborg, Bolette; Koch, Anders

2016-01-01

Background Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey – representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion This review successfully establishes baseline knowledge

Descriptive review of tuberculosis surveillance systems across the circumpolar regions.

PubMed

Bourgeois, Annie-Claude; Zulz, Tammy; Soborg, Bolette; Koch, Anders; On Behalf Of The International Circumpolar Surveillance-Tuberculosis Working Group

2016-01-01

Background Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB) Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design Three questionnaires were developed to reflect the different surveillance levels (local, regional and national); all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic), United States (Alaska)] voluntarily completed the survey - representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7) and commercial software (n=6). Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion This review successfully establishes baseline knowledge on

HIV-1 drug-resistance surveillance among treatment-experienced and -naïve patients after the implementation of antiretroviral therapy in Ghana.

PubMed

Nii-Trebi, Nicholas I; Ibe, Shiro; Barnor, Jacob S; Ishikawa, Koichi; Brandful, James A M; Ofori, Sampson B; Yamaoka, Shoji; Ampofo, William K; Sugiura, Wataru

2013-01-01

Limited HIV-1 drug-resistance surveillance has been carried out in Ghana since the implementation of antiretroviral therapy (ART). This study sought to provide data on the profile of HIV-1 drug resistance in ART-experienced and newly diagnosed individuals in Ghana. Samples were collected from 101 HIV-1-infected patients (32 ART-experienced cases with virological failure and 69 newly diagnosed ART-naïve cases, including 11 children), in Koforidua, Eastern region of Ghana, from February 2009 to January 2010. The pol gene sequences were analyzed by in-house HIV-1 drug-resistance testing. The most prevalent HIV-1 subtype was CRF02_AG (66.3%, 67/101) followed by unique recombinant forms (25.7%, 26/101). Among 31 ART-experienced adults, 22 (71.0%) possessed at least one drug-resistance mutation, and 14 (45.2%) had two-class-resistance to nucleoside and non-nucleoside reverse-transcriptase inhibitors used in their first ART regimen. Importantly, the number of accumulated mutations clearly correlated with the duration of ART. The most prevalent mutation was lamivudine-resistance M184V (n = 12, 38.7%) followed by efavirenz/nevirapine-resistance K103N (n = 9, 29.0%), and zidovudine/stavudine-resistance T215Y/F (n = 6, 19.4%). Within the viral protease, the major nelfinavir-resistance mutation L90M was found in one case. No transmitted HIV-1 drug-resistance mutation was found in 59 ART-naïve adults, but K103N and G190S mutations were observed in one ART-naïve child. Despite expanding accessibility to ART in Eastern Ghana, the prevalence of transmitted HIV-1 drug resistance presently appears to be low. As ART provision with limited options is scaled up nationwide in Ghana, careful monitoring of transmitted HIV-1 drug resistance is necessary.

Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths-Texas, 2008.

PubMed

Choudhary, Ekta; Zane, David F; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S; Martin, Colleen; Wolkin, Amy F; Bayleyegn, Tesfaye M

2012-08-01

The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. The objective of this study was to evaluate Texas DSHS' active mortality surveillance system using US Centers for Disease Control and Prevention's (CDC) surveillance system evaluation guidelines. Using CDC's Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Texas's active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates.

An integrated comprehensive occupational surveillance system for health care workers.

PubMed

Dement, John M; Pompeii, Lisa A; Østbye, Truls; Epling, Carol; Lipscomb, Hester J; James, Tamara; Jacobs, Michael J; Jackson, George; Thomann, Wayne

2004-06-01

Workers in the health care industry may be exposed to a variety of work-related stressors including infectious, chemical, and physical agents; ergonomic hazards; psychological hazards; and workplace violence. Many of these hazards lack surveillance systems to evaluate exposures and health outcomes. The development and implementation of a comprehensive surveillance system within the Duke University Health System (DUHS) that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of health care workers (HCWs) is presented. Human resources job and work location data were used to define the DUHS population at risk. Outcomes and exposure data from existing occupational health and safety programs, health promotion programs, and employee health insurance claims, were linked with human resources data and de-identified to create the Duke Health and Safety Surveillance System (DHSSS). The surveillance system is described and four examples are presented demonstrating how the system has successfully been used to study consequences of work-related stress, hearing conservation program evaluation, risk factors for back pain and inflammation, and exposures to blood and body fluids (BBF). Utilization of existing data, often collected for other purposes, can be successfully integrated and used for occupational health surveillance monitoring of HCWs. Use of the DHSSS for etiologic studies, benchmarking, and intervention program evaluation are discussed. Copyright 2004 Wiley-Liss, Inc.

The safety helmet detection technology and its application to the surveillance system.

PubMed

Wen, Che-Yen

2004-07-01

The Automatic Teller Machine (ATM) plays an important role in the modem economy. It provides a fast and convenient way to process transactions between banks and their customers. Unfortunately, it also provides a convenient way for criminals to get illegal money or use stolen ATM cards to extract money from their victims' accounts. For safety reasons, each ATM has a surveillance system to record customer's face information. However, when criminals use an ATM to withdraw money illegally, they usually hide their faces with something (in Taiwan, criminals usually use safety helmets to block their faces) to avoid the surveillance system recording their face information, which decreases the efficiency of the surveillance system. In this paper, we propose a circle/circular arc detection method based upon the modified Hough transform, and apply it to the detection of safety helmets for the surveillance system of ATMs. Since the safety helmet location will be within the set of the obtainable circles/circular arcs (if any exist), we use geometric features to verify if any safety helmet exists in the set. The proposed method can be used to help the surveillance systems record a customer's face information more precisely. If customers wear safety helmets to block their faces, the system can send a message to remind them to take off their helmets. Besides this, the method can be applied to the surveillance systems of banks by providing an early warning safeguard when any "customer" or "intruder" uses a safety helmet to avoid his/her face information from being recorded by the surveillance system. This will make the surveillance system more useful. Real images are used to analyze the performance of the proposed method.

[Construction of the Brazilian Sanitary Surveillance System: arguments to debate].

PubMed

De Seta, Marismary Horsth; Dain, Sulamis

2010-11-01

This paper analyzes the Brazilian Sanitary Surveillance System as an arrangement aimed at regulating and reducing health risks associated with consumption of products, use of health services and the environment. Historical, political and tax aspects were considered and their development compared with the National Health Surveillance System, which has received strong international cooperation. The comparison was based on the trajectory of their national systems and related federal agencies, as well as on criteria adopted for decentralization. The central category of analysis is federative coordination and was based on the framework of federalism and intergovernmental relations. The institutional context of health and sanitary surveillance presents strong political competition, instability in the project and probable reduction of the ability of federal coordination after the Pact for Health. The National Sanitary Surveillance System due to its nature of public good and high externality in its field of action requires federal coordination for increasing the regional and local cooperation, also because of the structural heterogeneity of Brazilian municipalities.

Surveillance and early warning systems of infectious disease in China: From 2012 to 2014.

PubMed

Zhang, Honglong; Wang, Liping; Lai, Shengjie; Li, Zhongjie; Sun, Qiao; Zhang, Peng

2017-07-01

Appropriate surveillance and early warning of infectious diseases have very useful roles in disease control and prevention. In 2004, China established the National Notifiable Infectious Disease Surveillance System and the Public Health Emergency Event Surveillance System to report disease surveillance and events on the basis of data sources from the National Notifiable Infectious Disease Surveillance System, China Infectious Disease Automated-alert and Response System in this country. This study provided a descriptive summary and a data analysis, from 2012 to 2014, of these 3 key surveillance and early warning systems of infectious disease in China with the intent to provide suggestions for system improvement and perfection. Copyright © 2017 John Wiley & Sons, Ltd.

Video coding for next-generation surveillance systems

NASA Astrophysics Data System (ADS)

Klasen, Lena M.; Fahlander, Olov

1997-02-01

Video is used as recording media in surveillance system and also more frequently by the Swedish Police Force. Methods for analyzing video using an image processing system have recently been introduced at the Swedish National Laboratory of Forensic Science, and new methods are in focus in a research project at Linkoping University, Image Coding Group. The accuracy of the result of those forensic investigations often depends on the quality of the video recordings, and one of the major problems when analyzing videos from crime scenes is the poor quality of the recordings. Enhancing poor image quality might add manipulative or subjective effects and does not seem to be the right way of getting reliable analysis results. The surveillance system in use today is mainly based on video techniques, VHS or S-VHS, and the weakest link is the video cassette recorder, (VCR). Multiplexers for selecting one of many camera outputs for recording is another problem as it often filters the video signal, and recording is limited to only one of the available cameras connected to the VCR. A way to get around the problem of poor recording is to simultaneously record all camera outputs digitally. It is also very important to build such a system bearing in mind that image processing analysis methods becomes more important as a complement to the human eye. Using one or more cameras gives a large amount of data, and the need for data compression is more than obvious. Crime scenes often involve persons or moving objects, and the available coding techniques are more or less useful. Our goal is to propose a possible system, being the best compromise with respect to what needs to be recorded, movements in the recorded scene, loss of information and resolution etc., to secure the efficient recording of the crime and enable forensic analysis. The preventative effective of having a well functioning surveillance system and well established image analysis methods is not to be neglected. Aspects of

Evaluation of the NASA Quality Surveillance System Pilot in Meeting Requirements for Contractor Surveillance Under Performance Based Contracting

NASA Technical Reports Server (NTRS)

Schmahl, Karen E.

2002-01-01

The use of performance-based contracting at Kennedy Space Center has necessitated a shift from intrusive oversight of contractor activities to an insight surveillance role. This paper describes the results of a pilot implementation of the NASA Quality Surveillance System (NQSS) in the Space Shuttle Main Engines Processing Facility. The NQSS is a system to sample contractor activities using documented procedures, specifications, drawings and observations of work in progress to answer the question "Is the contractor doing what they said they would do?" The concepts of the NQSS are shown to be effective in providing assurance of contractor quality. Many of the concepts proven in the pilot are being considered for incorporation into an overall KSC Quality Surveillance System.

Evaluation Of The NASA Quality Surveillance System Pilot In Meeting Requirements For Contractor Surveillance Under Performance Based Contracting

NASA Technical Reports Server (NTRS)

Schmahl, Karen E.

2001-01-01

The use of performance-based contracting at Kennedy Space Center has necessitated a shift from intrusive oversight of contractor activities to an insight surveillance role. This paper describes the results of a pilot implementation of the NASA Quality Surveillance System (NQSS) in the Space Shuttle Main Engines Processing Facility. The NQSS is a system to sample contractor activities using documented procedures, specifications, drawings and observations of work in progress to answer the question "Is the contractor doing what they said they would do?" The concepts of the NQSS are shown to be effective in providing assurance of contractor quality. Many of the concepts proven in the pilot are being considered for incorporation into an overall KSC Quality Surveillance System.

Smart sensing surveillance system

NASA Astrophysics Data System (ADS)

Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

2010-04-01

An effective public safety sensor system for heavily-populated applications requires sophisticated and geographically-distributed infrastructures, centralized supervision, and deployment of large-scale security and surveillance networks. Artificial intelligence in sensor systems is a critical design to raise awareness levels, improve the performance of the system and adapt to a changing scenario and environment. In this paper, a highly-distributed, fault-tolerant, and energy-efficient Smart Sensing Surveillance System (S4) is presented to efficiently provide a 24/7 and all weather security operation in crowded environments or restricted areas. Technically, the S4 consists of a number of distributed sensor nodes integrated with specific passive sensors to rapidly collect, process, and disseminate heterogeneous sensor data from near omni-directions. These distributed sensor nodes can cooperatively work to send immediate security information when new objects appear. When the new objects are detected, the S4 will smartly select the available node with a Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR camera to track the objects and capture associated imagery. The S4 provides applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. Other imaging processes can be updated to meet specific requirements and operations. In the S4, all the sensor nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology. This UWB RF technology can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The Service Oriented Architecture of S4 enables remote applications to interact with the S4

Evaluation of Active Mortality Surveillance System Data for Monitoring Hurricane-Related Deaths—Texas, 2008

PubMed Central

Choudhary, Ekta; Zane, David F.; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S.; Martin, Colleen; Wolkin, Amy F.; Bayleyegn, Tesfaye M.

2015-01-01

Introduction The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. Objective The objective of this study was to evaluate Texas DSHS’ active mortality surveillance system using US Centers for Disease Control and Prevention’s (CDC) surveillance system evaluation guidelines. Methods Using CDC’s Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. Results From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Conclusions Texas’s active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health

Surveillance of infectious diseases in the Arctic.

PubMed

Bruce, M; Zulz, T; Koch, A

2016-08-01

This study reviews how social and environmental issues affect health in Arctic populations and describes infectious disease surveillance in Arctic Nations with a special focus on the activities of the International Circumpolar Surveillance (ICS) project. We reviewed the literature over the past 2 decades looking at Arctic living conditions and their effects on health and Arctic surveillance for infectious diseases. In regards to other regions worldwide, the Arctic climate and environment are extreme. Arctic and sub-Arctic populations live in markedly different social and physical environments compared to those of their more southern dwelling counterparts. A cold northern climate means people spending more time indoors, amplifying the effects of household crowding, smoking and inadequate ventilation on the person-to-person spread of infectious diseases. The spread of zoonotic infections north as the climate warms, emergence of antibiotic resistance among bacterial pathogens, the re-emergence of tuberculosis, the entrance of HIV into Arctic communities, the specter of pandemic influenza or the sudden emergence and introduction of new viral pathogens pose new challenges to residents, governments and public health authorities of all Arctic countries. ICS is a network of hospitals, public health agencies, and reference laboratories throughout the Arctic working together for the purposes of collecting, comparing and sharing of uniform laboratory and epidemiological data on infectious diseases of concern and assisting in the formulation of prevention and control strategies (Fig. 1). In addition, circumpolar infectious disease research workgroups and sentinel surveillance systems for bacterial and viral pathogens exist. The ICS system is a successful example of collaborative surveillance and research in an extreme environment. Published by Elsevier Ltd.

Increases in Recent HIV Testing Among Men Who Have Sex With Men Coincide With the Centers for Disease Control and Prevention's Expanded Testing Initiative

PubMed Central

Cooley, Laura A.; Wejnert, Cyprian; Rose, Charles E.; Paz-Bailey, Gabriela; Taussig, Jennifer; Gern, Robert; Hoyte, Tamika; Salazar, Laura; White, Jianglan; Todd, Jeff; Bautista, Greg; Flynn, Colin; Sifakis, Frangiscos; German, Danielle; Isenberg, Debbie; Driscoll, Maura; Hurwitz, Elizabeth; Doherty, Rose; Wittke, Chris; Prachand, Nikhil; Benbow, Nanette; Melville, Sharon; Pannala, Praveen; Yeager, Richard; Sayegh, Aaron; Dyer, Jim; Sheu, Shane; Novoa, Alicia; Thrun, Mark; Al-Tayyib, Alia; Wilmoth, Ralph; Higgins, Emily; Griffin, Vivian; Mokotoff, Eve; MacMaster, Karen; Wolverton, Marcia; Risser, Jan; Rehman, Hafeez; Padgett, Paige; Bingham, Trista; Sey, Ekow Kwa; LaLota, Marlene; Metsch, Lisa; Forrest, David; Beck, Dano; Cardenas, Gabriel; Nemeth, Chris; Anderson, Bridget J.; Watson, Carol-Ann; Smith, Lou; Robinson, William T.; Gruber, DeAnn; Barak, Narquis; Murrill, Chris; Neaigus, Alan; Jenness, Samuel; Hagan, Holly; Reilly, Kathleen H.; Wendel, Travis; Cross, Helene; Bolden, Barbara; D'Errico, Sally; Wogayehu, Afework; Godette, Henry; Brady, Kathleen A.; Kirkland, Althea; Sifferman, Andrea; Miguelino-Keasling, Vanessa; Velasco, Al; Tovar, Veronica; Raymond, H. Fisher; De León, Sandra Miranda; Rolón-Colón, Yadira; Marzan, Melissa; Courogen, Maria; Jaenicke, Tom; Thiede, Hanne; Burt, Richard; Jia, Yujiang; Opoku, Jenevieve; Sansone, Marie; West, Tiffany; Magnus, Manya; Kuo, Irene

2015-01-01

According to National HIV Behavioral Surveillance system data, human immunodeficiency virus (HIV) testing increased among gay, bisexual, and other men who have sex with men from 2008 to 2011 in cities funded by the Centers for Disease Control and Prevention's Expanded Testing Initiative, suggesting that focused HIV testing initiatives might have positive effects. PMID:25352589

Hepatocellular Carcinoma Surveillance Rates in Commercially Insured Patients with Non-Cirrhotic Chronic Hepatitis B

PubMed Central

Goldberg, David S.; Valderrama, Adriana; Kamalakar, Rajesh; Sansgiry, Sujit S; Babajanyan, Svetlana; Lewis, James D.

2015-01-01

AASLD and EASL guidelines recommend biannual hepatocellular carcinoma (HCC) screening for non-cirrhotic patients with chronic hepatitis B infection (HBV), yet there are no data estimating surveillance rates or factors associated with surveillance. We performed a retrospective cohort study of U.S. patients using the Truven Health Analytics databases from 2006-2010, and identified patients with non-cirrhotic chronic HBV. Surveillance patterns were characterized using categorical and continuous outcomes, with the continuous measure of the proportion of time “up-to-date” with surveillance (PUTDS), with the six-month interval following each ultrasound categorized as “up-to-date.” During a median follow-up of 26.0 (IQR: 16.2-40.0) months among 4,576 non-cirrhotic patients with chronic HBV (median age: 44 years, IQR: 36-52), only 306 (6.7%) had complete surveillance (one ultrasound every 6-month interval), 2,727 (59.6%) incomplete (≥1 ultrasound), and 1,543 (33.7%) none. The mean PUTDS was 0.34 ± 0.29, and the median was 0.32 (IQR: 0.03-0.52). In multinomial logistic regression models, patients diagnosed by a non-gastroenterologist were significantly less likely to have complete surveillance (p<0.001), as were those co-infected with HBV/HIV (p<0.001). In linear regression models, non-gastroenterologist provider, health insurance subtype, HBV/HIV co-infection, rural status, and metabolic syndrome were independently associated with decreased surveillance. Patients with HIV had an absolute decrease in the PUTDS of 0.24, while patients in less populated rural areas had an absolute decrease of 0.10. HCC surveillance rates in non-cirrhotic patients with chronic HBV in the United States are poor, and lower than reported rates of HCC surveillance in cirrhotic patients. PMID:25581816

Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games.

PubMed

Harcourt, S E; Fletcher, J; Loveridge, P; Bains, A; Morbey, R; Yeates, A; McCloskey, B; Smyth, B; Ibbotson, S; Smith, G E; Elliot, A J

2012-12-01

Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.

Remote-Reading Safety and Safeguards Surveillance System for 3013 Containers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lechelt, W. M.; Skorpik, J. R.; Silvers, K. L.

2002-02-26

At Hanford's Plutonium Finishing Plant (PFP), plutonium oxide is being loaded into stainless steel containers for long-term storage on the Hanford Site. These containers consist of two weld-sealed stainless steel cylinders nested one within the other. A third container holds the plutonium within the inner cylinder. This design meets the U.S. Department of Energy (DOE) storage standard, DOE-STD- 3013-2000, which anticipates a 50-year storage lifetime. The 3013 standard also requires a container surveillance program to continuously monitor pressure and to assure safeguards are adequate. However, the configuration of the container system makes using conventional measurement and monitoring methods difficult. Tomore » better meet the 3013 monitoring requirements, a team from Fluor Hanford (who manages the PFP), Pacific Northwest National Laboratory (PNNL), and Vista Engineering Technologies, LLC, developed a safer, cost-efficient, remote PFP 3013 container surveillance system. This new surveillance system is a combination of two successfully deployed technologies: (1) a magnetically coupled pressure gauge developed by Vista Engineering and (2) a radio frequency (RF) tagging device developed by PNNL. This system provides continuous, 100% monitoring of critical parameters with the containers in place, as well as inventory controls. The 3013 container surveillance system consists of three main elements: (1) an internal magnetic pressure sensor package, (2) an instrument pod (external electronics package), and (3) a data acquisition storage and display computer. The surveillance system described in this paper has many benefits for PFP and DOE in terms of cost savings and reduced personnel exposure. In addition, continuous safety monitoring (i.e., internal container pressure and temperature) of every container is responsible nuclear material stewardship and fully meets and exceeds DOE's Integrated Surveillance Program requirements.« less

Comparing national infectious disease surveillance systems: China and the Netherlands.

PubMed

Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

2017-05-08

Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks. A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts. The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals. Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.

HIV Diagnoses and Care Among Transgender Persons and Comparison With Men Who Have Sex With Men: New York City, 2006-2011.

PubMed

Wiewel, Ellen Weiss; Torian, Lucia V; Merchant, Pooja; Braunstein, Sarah L; Shepard, Colin W

2016-03-01

We measured HIV care outcomes of transgender persons, who have high HIV infection rates but are rarely distinguished from men who have sex with men (MSM) in HIV surveillance systems. New York City's surveillance registry includes HIV diagnoses since 2000 and HIV laboratory test results for transgender persons since 2005. We determined immunological status at diagnosis, delayed linkage to care, and nonachievement of viral suppression 1 year after diagnosis for transgender persons diagnosed with HIV in 2006 to 2011 and compared transgender women with MSM. In 2006 to 2011, 264 of 23 805 persons diagnosed with HIV were transgender (1%): 98% transgender women and 2% transgender men. Compared with MSM, transgender women had similar CD4 counts at diagnosis and rates of concurrent HIV/AIDS and delayed linkage to care but increased odds of not achieving suppression (adjusted odds ratio = 1.56; 95% confidence interval = 1.13, 2.16). Compared with MSM, transgender women in New York City had similar immunological status at diagnosis but lagged in achieving viral suppression. To provide appropriate assistance along the HIV care continuum, HIV care providers should accurately identify transgender persons.

NATIONAL NOSOCOMIAL INFECTIONS SURVEILLANCE SYSTEM (NNIS)

EPA Science Inventory

The National Nosocomial Infections Surveillance (NNIS) System is a cooperative effort that began in 1970 between the Centers for Disease Control and Prevention (CDC) and participating hospitals to create a national nosocomial infections database. The database is used to describe ...

Update on the Epidemiology and Prevention of HIV/AIDS in the United States

PubMed Central

Castel, Amanda D.; Magnus, Manya; Greenberg, Alan E.

2015-01-01

This update on the epidemiology and prevention of HIV in the United States is intended to provide contextual background that will help inform an understanding of recent developments in the domestic HIV epidemic. We describe the epidemiology of HIV disease in the US and the HIV continuum of care based on data collected primarily through HIV surveillance systems led by the Centers for Disease Control and Prevention including HIV incidence, prevalence, comorbidities and death. Populations and geographic regions disparately impacted by HIV are also highlighted. The HIV prevention armamentarium is also described including behavioral approaches to prevention, the emerging availability of biomedical prevention interventions such as pre-exposure prophylaxis, and structural and population-level interventions including treatment as prevention. Finally gaps in our understanding of the epidemic are underscored and suggestions for future epidemiologic research are proposed. PMID:25960941

Treating HIV infected mothers reduces mortality in children under 5 years of age to levels seen in children of HIV uninfected mothers: evidence from rural South Africa

PubMed Central

Ndirangu, James; Newell, Marie-Louise; Thorne, Claire; Bland, Ruth

2012-01-01

Background Maternal and child survival are highly correlated, but the contribution of HIV infection on this relationship, and in particular the impact of HIV treatment has not been quantified. We estimate the association between maternal HIV and treatment and under-5 child mortality in a rural population in South Africa. Methods All children born between January 2000-January 2007 in the Africa Centre Demographic Surveillance Area were included. Maternal HIV status information was available from HIV surveillance; maternal antiretroviral treatment (ART) from the HIV Treatment Programme database and linked to surveillance data. Mortality rates were computed as deaths per 1000 person-years observed. Time-varying maternal HIV effect (positive, negative, ART) on U5MR was assessed in Cox regression, adjusting for other factors associated with under-5 mortality. Results 9,068 mothers delivered 12,052 children, of whom 947 (7.9%) died before age 5. Infant mortality rate (IMR) declined by 49% from 69.0 in 2000 to 35.5 in 2006 deaths per 1000 person-years observed; a significantly decline was observed post-ART (2004-2006). The estimated proportion of deaths across all age groups were higher among the children born to the HIV-positive and HIV-not reported status women than among children of HIV-negative women. Multivariably, mortality in children of mothers on ART was not significantly different from children of HIV-negative mothers (aHR 1.29, 0.53-3.17; p=0.572). Conclusions These findings highlight the importance of maternal HIV treatment with direct benefits of improved survival among all children under-5. Timely HIV treatment for eligible women is required to benefit both mothers and children. PMID:22267472

HIV/AIDS behavioral surveillance among Angolan military men.

PubMed

Bing, Eric G; Ortiz, Daniel J; Ovalle-Bahamón, Ricardo E; Cheng, Karen G; Huang, Fannie H; Ernesto, Francisco; Duan, Naihua

2008-07-01

To assess HIV-related risk behavior among military men in a post-conflict sub-Saharan African country with low HIV prevalence this study evaluated sexual risk taking and related behaviors among a stratified random sample of 1,710 military personnel in four regions of Angola. Over 90% were sexually active and 60% had two or more sexual partners within the past year. Condom use varied depending on partner type, from a low of 10% to a high of 54%. Factors independently predicting the number of sexual partners included younger age, younger age of sexual debut, being away from home, being in the eastern part of the country, higher military rank, higher education, alcohol before sex, and problem alcohol use. Independent predictors of sexually transmitted infection symptoms included age of sexual debut, lower education, higher rank, and having had sex with a casual partner or a commercial sex worker in the previous 12 months. These findings indicate high rates of HIV risk-taking behaviors among military personnel and the need for aggressive prevention campaigns to reduce HIV risk among military personnel and the populations they serve.

A Pan-HIV Strategy for Complete Genome Sequencing

PubMed Central

Yamaguchi, Julie; Alessandri-Gradt, Elodie; Tell, Robert W.; Brennan, Catherine A.

2015-01-01

Molecular surveillance is essential to monitor HIV diversity and track emerging strains. We have developed a universal library preparation method (HIV-SMART [i.e., switching mechanism at 5′ end of RNA transcript]) for next-generation sequencing that harnesses the specificity of HIV-directed priming to enable full genome characterization of all HIV-1 groups (M, N, O, and P) and HIV-2. Broad application of the HIV-SMART approach was demonstrated using a panel of diverse cell-cultured virus isolates. HIV-1 non-subtype B-infected clinical specimens from Cameroon were then used to optimize the protocol to sequence directly from plasma. When multiplexing 8 or more libraries per MiSeq run, full genome coverage at a median ∼2,000× depth was routinely obtained for either sample type. The method reproducibly generated the same consensus sequence, consistently identified viral sequence heterogeneity present in specimens, and at viral loads of ≤4.5 log copies/ml yielded sufficient coverage to permit strain classification. HIV-SMART provides an unparalleled opportunity to identify diverse HIV strains in patient specimens and to determine phylogenetic classification based on the entire viral genome. Easily adapted to sequence any RNA virus, this technology illustrates the utility of next-generation sequencing (NGS) for viral characterization and surveillance. PMID:26699702

Age biases in a large HIV and sexual behaviour-related internet survey among MSM.

PubMed

Marcus, Ulrich; Hickson, Ford; Weatherburn, Peter; Schmidt, Axel J

2013-09-10

Behavioural data from MSM are usually collected in non-representative convenience samples, increasingly on the internet. Epidemiological data from such samples might be useful for comparisons between countries, but are subject to unknown participation biases. Self-reported HIV diagnoses from participants of the European MSM Internet Survey (EMIS) living in the Czech Republic, Germany, The Netherlands, Portugal, Sweden and the United Kingdom were compared with surveillance data, for both the overall diagnosed prevalence and for new diagnoses made in 2009. Country level prevalence and new diagnoses rates per 100 MSM were calculated based on an assumed MSM population size of 3% of the adult male population. Survey-surveillance discrepancies (SSD) for survey participation, diagnosed HIV prevalence and new HIV diagnoses were determined as ratios of proportions. Results are calculated and presented by 5-year age groups for MSM aged 15-64. Surveillance derived estimates of diagnosed HIV prevalence among MSM aged 15-64 ranged from 0.63% in the Czech Republic to 4.93% in The Netherlands. New HIV diagnoses rates ranged between 0.10 per 100 MSM in the Czech Republic and 0.48 per 100 in The Netherlands. Self-reported rates from EMIS were consistently higher, with prevalence ranging from 2.68% in the Czech Republic to 12.72% in The Netherlands, and new HIV diagnoses rates from 0.36 per 100 in Sweden to 1.44 per 100 in The Netherlands. Across age groups, the survey surveillance discrepancies (SSD) for new HIV diagnoses were between 1.93 in UK and 5.95 in the Czech Republic, and for diagnosed prevalence between 1.80 in Germany and 4.26 in the Czech Republic.Internet samples of MSM were skewed towards younger age groups when compared to an age distribution of the general adult male population. Survey-surveillance discrepancies (SSD) for EMIS participation were inverse u-shaped across the age range. The two HIV-related SSD were u- or j-shaped with higher values for the very young

NATIONAL ORAL HEALTH SURVEILLANCE SYSTEM (NOHSS)

EPA Science Inventory

National Oral Health Surveillance System (NOHSS) is a collaborative effort between CDC's Division of Oral Health and The Association of State and Territorial Dental Directors (ASTDD). NOHSS is designed to help public health programs monitor the burden of oral disease, use of the ...

77 FR 6000 - Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and Collision... Communication & Surveillance Systems (ACSS) traffic alert and collision avoidance system (TCAS) units with part...

High HIV Burden in Men Who Have Sex with Men across Colombia's Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study.

PubMed

Rubio Mendoza, Martha Lucía; Jacobson, Jerry Owen; Morales-Miranda, Sonia; Sierra Alarcón, Clara Ángela; Luque Núñez, Ricardo

2015-01-01

Among Latin America's concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region's third largest country. To date, surveillance studies have been limited to Bogota, while 80% of HIV cases and deaths originate from Colombia's other cities and departments. The extent to which interventions should prioritize MSM outside of Bogota is unknown. We recruited 2603 MSM using respondent-driven sampling from seven of Colombia's largest cities. HIV prevalence was estimated by site from dried blood spot samples. Behavioral data were collected through face-to-face interviews and risk factors for HIV infection analyzed using weighted, multi-level logistical regression models accounting for recruitment patterns. Across cities, HIV prevalence averaged 15%, varied from 6% to 24% and was highest in Cali, Bogota, and Barranquilla. In the past 12 months, 65% of MSM had ≥ 5 casual male partners and 23% had a female partner. Across partnerships (i.e., casual, stable, and commercial), the proportion of MSM engaging in unprotected sex was ≥ 52% with male partners and ≥ 66% with female partners. Self-reported history of STI (24%) and past-year illicit drug use (38%) were also common. In multivariate analysis, age ≥ 35 (adjusted odds ratio [AOR], 19.2) and 25-39 (AOR, 5.6) relative to ≤ 18-24 years, identifying as homosexual relative to heterosexual (AOR 0.1), meeting casual partners on the Internet (adjusted odds ratio [AOR], 3.1) and age of sexual debut of ≤ 13 years (AOR, 3.1) predicted HIV infection. HIV testing and prevention messaging reached just 24% of MSM in the past year. Findings support consistently elevated HIV burden among MSM throughout Colombia's largest cities and a need for enhanced behavioral prevention and HIV testing, emphasizing men who use the Internet as well as physical venues to meet sex partners.

Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV.

PubMed

Bull, Sheana; Thomas, Deborah Sk; Nyanza, Elias C; Ngallaba, Sospatro E

2018-01-15

The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention

Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV

PubMed Central

Bull, Sheana; Nyanza, Elias C; Ngallaba, Sospatro E

2018-01-01

Background The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. Objective The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. Methods We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Results Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. Conclusions T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more

Surveillance and reconnaissance ground system architecture

NASA Astrophysics Data System (ADS)

Devambez, Francois

2001-12-01

Modern conflicts induces various modes of deployment, due to the type of conflict, the type of mission, and phase of conflict. It is then impossible to define fixed architecture systems for surveillance ground segments. Thales has developed a structure for a ground segment based on the operational functions required, and on the definition of modules and networks. Theses modules are software and hardware modules, including communications and networks. This ground segment is called MGS (Modular Ground Segment), and is intended for use in airborne reconnaissance systems, surveillance systems, and U.A.V. systems. Main parameters for the definition of a modular ground image exploitation system are : Compliance with various operational configurations, Easy adaptation to the evolution of theses configurations, Interoperability with NATO and multinational forces, Security, Multi-sensors, multi-platforms capabilities, Technical modularity, Evolutivity Reduction of life cycle cost The general performances of the MGS are presented : type of sensors, acquisition process, exploitation of images, report generation, data base management, dissemination, interface with C4I. The MGS is then described as a set of hardware and software modules, and their organization to build numerous operational configurations. Architectures are from minimal configuration intended for a mono-sensor image exploitation system, to a full image intelligence center, for a multilevel exploitation of multi-sensor.

HIV Diagnoses and Care Among Transgender Persons and Comparison With Men Who Have Sex With Men: New York City, 2006–2011

PubMed Central

Torian, Lucia V.; Merchant, Pooja; Braunstein, Sarah L.; Shepard, Colin W.

2016-01-01

Objectives. We measured HIV care outcomes of transgender persons, who have high HIV infection rates but are rarely distinguished from men who have sex with men (MSM) in HIV surveillance systems. Methods. New York City’s surveillance registry includes HIV diagnoses since 2000 and HIV laboratory test results for transgender persons since 2005. We determined immunological status at diagnosis, delayed linkage to care, and nonachievement of viral suppression 1 year after diagnosis for transgender persons diagnosed with HIV in 2006 to 2011 and compared transgender women with MSM. Results. In 2006 to 2011, 264 of 23 805 persons diagnosed with HIV were transgender (1%): 98% transgender women and 2% transgender men. Compared with MSM, transgender women had similar CD4 counts at diagnosis and rates of concurrent HIV/AIDS and delayed linkage to care but increased odds of not achieving suppression (adjusted odds ratio = 1.56; 95% confidence interval = 1.13, 2.16). Conclusions. Compared with MSM, transgender women in New York City had similar immunological status at diagnosis but lagged in achieving viral suppression. To provide appropriate assistance along the HIV care continuum, HIV care providers should accurately identify transgender persons. PMID:26691124

Centers for Disease Control and Prevention Funding for HIV Testing Associated With Higher State Percentage of Persons Tested.

PubMed

Hayek, Samah; Dietz, Patricia M; Van Handel, Michelle; Zhang, Jun; Shrestha, Ram K; Huang, Ya-Lin A; Wan, Choi; Mermin, Jonathan

2015-01-01

To assess the association between state per capita allocations of Centers for Disease Control and Prevention (CDC) funding for HIV testing and the percentage of persons tested for HIV. We examined data from 2 sources: 2011 Behavioral Risk Factor Surveillance System and 2010-2011 State HIV Budget Allocations Reports. Behavioral Risk Factor Surveillance System data were used to estimate the percentage of persons aged 18 to 64 years who had reported testing for HIV in the last 2 years in the United States by state. State HIV Budget Allocations Reports were used to calculate the state mean annual per capita allocations for CDC-funded HIV testing reported by state and local health departments in the United States. The association between the state fixed-effect per capita allocations for CDC-funded HIV testing and self-reported HIV testing in the last 2 years among persons aged 18 to 64 years was assessed with a hierarchical logistic regression model adjusting for individual-level characteristics. The percentage of persons tested for HIV in the last 2 years. In 2011, 18.7% (95% confidence interval = 18.4-19.0) of persons reported being tested for HIV in last 2 years (state range, 9.7%-28.2%). During 2010-2011, the state mean annual per capita allocation for CDC-funded HIV testing was $0.34 (state range, $0.04-$1.04). A $0.30 increase in per capita allocation for CDC-funded HIV testing was associated with an increase of 2.4 percentage points (14.0% vs 16.4%) in the percentage of persons tested for HIV per state. Providing HIV testing resources to health departments was associated with an increased percentage of state residents tested for HIV.

Burden and Correlates of HIV among Men Who Have Sex with Men in West Bengal, India: Analysis of Sentinel Surveillance Data.

PubMed

Mahapatra, Tanmay; Biswas, Subrata; Nandi, Srijita; Ghosh, Piyali; Ghosh, Mallika; Mondal, Soumya; Saha, Malay K

2015-01-01

Little is known about the socio-behavioral risk factors for HIV acquisition among hard-to-reach men who have sex with men (MSM) population in India, particularly from the densely populated eastern part. Thus to measure the burden and correlates of HIV among MSM in West Bengal state of eastern India, a cross-sectional analysis of the national HIV Sentinel Surveillance (HSS) data was conducted. In 2011, between July and September, involving all sentinel sites of the state, 1237 consenting MSM were anonymously interviewed and tested for HIV following national guidelines. Using a short, structured questionnaire, information was collected on socio-behavioral factors along with sexual practices and was analyzed to determine burden of HIV and the role of its socio-behavioral correlates on HIV acquisition. Among participants, mean age was 23.4 years, 44.55% were "Kothis" (usually receptive partner) and 25.1% admitted receiving money for sex with man. HIV sero-positivity was 5.09%. Using logistic regression method, for both bivariate and multivariate (with saturated model) analyses, transport-workers [adjusted odds ratio (AOR)=8.95, 95% confidence interval (95%CI): 1.09-73.71), large business-owners/self-employed (AOR=8.46, 95%CI: 1.25-57.49), small business-owners/cultivators (AOR=7.90, 95%CI: 1.67-37.38), those who visited the sentinel site for official purposes (AOR=7.60, 95%CI: 1.21-47.83) and paying money for having sex with men (AOR=3.03, 95%CI: 1.10-8.33) were strongly associated with higher HIV sero-positivity with than their counterparts. Using the parsimonious model for multivariate analysis, Kothis (AOR=4.64, 95%CI: 1.03-20.89), paying (AOR=2.96, 95%CI: 1.15-7.58) or receiving (AOR=2.06, 95%CI: 1.06-3.99) money for having sex with a man were associated with higher risk of HIV. Focused intervention targeting the high risk MSM subgroups including Kothis, transport-workers, business-owners/self-employed and those who exchanged money for having sex with men, seemed

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis.

PubMed

Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings.

Enhanced HIV-1 surveillance using molecular epidemiology to study and monitor HIV-1 outbreaks among intravenous drug users (IDUs) in Athens and Bucharest.

PubMed

Paraskevis, Dimitrios; Paraschiv, Simona; Sypsa, Vana; Nikolopoulos, Georgios; Tsiara, Chryssa; Magiorkinis, Gkikas; Psichogiou, Mina; Flampouris, Andreas; Mardarescu, Mariana; Niculescu, Iulia; Batan, Ionelia; Malliori, Meni; Otelea, Dan; Hatzakis, Angelos

2015-10-01

A significant increase in HIV-1 diagnoses was reported among Injecting Drug Users (IDUs) in the Athens (17-fold) and Bucharest (9-fold) metropolitan areas starting 2011. Molecular analyses were conducted on HIV-1 sequences from IDUs comprising 51% and 20% of the diagnosed cases among IDUs during 2011-2013 for Greece and Romania, respectively. Phylodynamic analyses were performed using the newly developed birth-death serial skyline model which allows estimating of important epidemiological parameters, as implemented in BEAST programme. Most infections (>90%) occurred within four and three IDU local transmission networks in Athens and Bucharest, respectively. For all Romanian clusters, the viral strains originated from local circulating strains, whereas in Athens, the local strains seeded only two of the four sub-outbreaks. Birth-death skyline plots suggest a more explosive nature for sub-outbreaks in Bucharest than in Athens. In Athens, two sub-outbreaks had been controlled (Re<1.0) by 2013 and two appeared to be endemic (Re∼1). In Bucharest one outbreak continued to expand (Re>1.0) and two had been controlled (Re<1.0). The lead times were shorter for the outbreak in Athens than in Bucharest. Enhanced molecular surveillance proved useful to gain information about the origin, causal pathways, dispersal patterns and transmission dynamics of the outbreaks that can be useful in a public health setting. Copyright © 2015 Elsevier B.V. All rights reserved.

Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

PubMed

Mizuno, Yuko; Zhu, Julia; Crepaz, Nicole; Beer, Linda; Purcell, David W; Johnson, Christopher H; Valverde, Eduardo E; Skarbinski, Jacek

2014-01-28

Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions. Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States. Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable. About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions. HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.

76 FR 62321 - Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

... Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) Units AGENCY... certain Aviation Communication & Surveillance Systems (ACSS) traffic alert and collision avoidance system...) traffic alert and collision avoidance system (TCAS) units with part numbers identified in ACSS Technical...

AIDS in Black and White: The Influence of Newspaper Coverage of HIV/AIDS on HIV/AIDS Testing Among African Americans and White Americans, 1993–2007

PubMed Central

STEVENS, ROBIN; HORNIK, ROBERT C.

2014-01-01

This study examined the impact of newspaper coverage of HIV/AIDS on HIV testing behavior in the US population. HIV testing data were taken from the CDC’s National Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2007 (n=265,557). News stories from 24 daily newspapers and one wire service during the same time period were content analyzed. Distributed lagged regression models were employed to estimate how well HIV/AIDS newspaper coverage predicted later HIV testing behavior. Increases in HIV/AIDS newspaper coverage were associated with declines in population level HIV testing. Each additional 100 HIV/AIDS related newspaper stories published each month was associated with a 1.7% decline in HIV testing levels in the subsequent month. This effect differed by race, with African Americans exhibiting greater declines in HIV testing subsequent to increased news coverage than did Whites. These results suggest that mainstream newspaper coverage of HIV/AIDS may have a particularly deleterious effect on African Americans, one of the groups most impacted by the disease. The mechanisms driving the negative effect deserve further investigation to improve reporting on HIV/AIDS in the media. PMID:24597895

Sampling Key Populations for HIV Surveillance: Results From Eight Cross-Sectional Studies Using Respondent-Driven Sampling and Venue-Based Snowball Sampling

PubMed Central

Stahlman, Shauna; Hargreaves, James; Weir, Sharon; Edwards, Jessie; Rice, Brian; Kochelani, Duncan; Mavimbela, Mpumelelo; Baral, Stefan

2017-01-01

Background In using regularly collected or existing surveillance data to characterize engagement in human immunodeficiency virus (HIV) services among marginalized populations, differences in sampling methods may produce different pictures of the target population and may therefore result in different priorities for response. Objective The objective of this study was to use existing data to evaluate the sample distribution of eight studies of female sex workers (FSW) and men who have sex with men (MSM), who were recruited using different sampling approaches in two locations within Sub-Saharan Africa: Manzini, Swaziland and Yaoundé, Cameroon. Methods MSM and FSW participants were recruited using either respondent-driven sampling (RDS) or venue-based snowball sampling. Recruitment took place between 2011 and 2016. Participants at each study site were administered a face-to-face survey to assess sociodemographics, along with the prevalence of self-reported HIV status, frequency of HIV testing, stigma, and other HIV-related characteristics. Crude and RDS-adjusted prevalence estimates were calculated. Crude prevalence estimates from the venue-based snowball samples were compared with the overlap of the RDS-adjusted prevalence estimates, between both FSW and MSM in Cameroon and Swaziland. Results RDS samples tended to be younger (MSM aged 18-21 years in Swaziland: 47.6% [139/310] in RDS vs 24.3% [42/173] in Snowball, in Cameroon: 47.9% [99/306] in RDS vs 20.1% [52/259] in Snowball; FSW aged 18-21 years in Swaziland 42.5% [82/325] in RDS vs 8.0% [20/249] in Snowball; in Cameroon 15.6% [75/576] in RDS vs 8.1% [25/306] in Snowball). They were less educated (MSM: primary school completed or less in Swaziland 42.6% [109/310] in RDS vs 4.0% [7/173] in Snowball, in Cameroon 46.2% [138/306] in RDS vs 14.3% [37/259] in Snowball; FSW: primary school completed or less in Swaziland 86.6% [281/325] in RDS vs 23.9% [59/247] in Snowball, in Cameroon 87.4% [520/576] in RDS vs 77.5% [238

Evaluation of a Multivariate Syndromic Surveillance System for West Nile Virus.

PubMed

Faverjon, Céline; Andersson, M Gunnar; Decors, Anouk; Tapprest, Jackie; Tritz, Pierre; Sandoz, Alain; Kutasi, Orsolya; Sala, Carole; Leblond, Agnès

2016-06-01

Various methods are currently used for the early detection of West Nile virus (WNV) but their outputs are not quantitative and/or do not take into account all available information. Our study aimed to test a multivariate syndromic surveillance system to evaluate if the sensitivity and the specificity of detection of WNV could be improved. Weekly time series data on nervous syndromes in horses and mortality in both horses and wild birds were used. Baselines were fitted to the three time series and used to simulate 100 years of surveillance data. WNV outbreaks were simulated and inserted into the baselines based on historical data and expert opinion. Univariate and multivariate syndromic surveillance systems were tested to gauge how well they detected the outbreaks; detection was based on an empirical Bayesian approach. The systems' performances were compared using measures of sensitivity, specificity, and area under receiver operating characteristic curve (AUC). When data sources were considered separately (i.e., univariate systems), the best detection performance was obtained using the data set of nervous symptoms in horses compared to those of bird and horse mortality (AUCs equal to 0.80, 0.75, and 0.50, respectively). A multivariate outbreak detection system that used nervous symptoms in horses and bird mortality generated the best performance (AUC = 0.87). The proposed approach is suitable for performing multivariate syndromic surveillance of WNV outbreaks. This is particularly relevant, given that a multivariate surveillance system performed better than a univariate approach. Such a surveillance system could be especially useful in serving as an alert for the possibility of human viral infections. This approach can be also used for other diseases for which multiple sources of evidence are available.

HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

PubMed

McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

2017-04-05

Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major

An update on the prevalence of HIV/AIDS in Bangladesh.

PubMed

Islam, M M; Karim, E; Mian, M A; Kristensen, S; Chowdhury, M R; Vermund, S H

1999-06-01

The National AIDS Committee was formed in 1985 to develop and support policies that prevent transmission of human immunodeficiency virus (HIV). In 1990, the Institute of Epidemiology, Disease Control and Research in the Ministry of Health began sero-surveillance for AIDS/HIV infection. Convenience sampling was conducted among prisoners, sailors, truckers, antenatal attendees, repatriated Bangladeshi workers, and brothel-based prostitutes in Dhaka. In 1994, commercial sex workers in other high-risk areas were included in surveillance activities. Among over 75,700 HIV tests through 1998, 119 have been confirmed positive for HIV. While the cumulative HIV prevalence rate was only 1.5/1,000 tests, it was significantly higher among men (p < 0.0001) than among women. The rates among men were as high as 28/1,000 tests in 1996 and 21/1,000 tests in 1997. Almost 50% of the reported HIV cases are from cities on the border of India and Myanmar. It is anticipated that HIV transmission will increase further given the high prevalence of risk behaviors, core high-risk groups, and extreme poverty.

77 FR 52742 - Public Meeting-Strengthening the National Medical Device Postmarket Surveillance System; Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

...] Public Meeting--Strengthening the National Medical Device Postmarket Surveillance System; Request for... ``Public Meeting--Strengthening the National Medical Device Postmarket Surveillance System.'' The purpose of the meeting is to solicit public feedback regarding the medical device postmarket surveillance...

Towards an electronic national injury surveillance system in Saudi Arabia.

PubMed

Alanazi, F; Hussain, S A; Mandil, A; Alamro, N

2015-04-02

Given the need for a uniform, comprehensive, electronic nationwide surveillance system for injuries in Saudi Arabia, a system was designed with the objectives of establishing an epidemiologic profile of injuries in the country; evaluating injury indicators on an ongoing basis; identifying high-risk groups requiring specific interventions; monitoring and evaluating interventions for effectiveness; and producing reports to assist in planning and resource allocation. A special form for this purpose was designed, modified from validated forms used elsewhere for injury surveillance. This initiative of the Ministry of Health is also expected to help validate data collected by other sectors, such as the Ministry of Interior. This paper reviews the milestones of building the system and aims to prompt a debate within the scientific community, especially within the Eastern Mediterranean Region, about the best way to design injury surveillance systems for the Region in order to fine-tune the proposed system before its full-scale implementation.

A visual surveillance system for person re-identification

NASA Astrophysics Data System (ADS)

El-Alfy, Hazem; Muramatsu, Daigo; Teranishi, Yuuichi; Nishinaga, Nozomu; Makihara, Yasushi; Yagi, Yasushi

2017-03-01

We attempt the problem of autonomous surveillance for person re-identification. This is an active research area, where most recent work focuses on the open challenges of re-identification, independently of prerequisites of detection and tracking. In this paper, we are interested in designing a complete surveillance system, joining all the pieces of the puzzle together. We start by collecting our own dataset from multiple cameras. Then, we automate the process of detection and tracking of human subjects in the scenes, followed by performing the re-identification task. We evaluate the recognition performance of our system, report its strengths, discuss open challenges and suggest ways to address them.

Low-cost inflatable lighter-than-air surveillance system for civilian applications

NASA Astrophysics Data System (ADS)

Kiddy, Jason S.; Chen, Peter C.; Niemczuk, John B.

2002-08-01

Today's society places an extremely high price on the value of human life and injury. Whenever possible, police and paramilitary actions are always directed towards saving as many lives as possible, whether it is the officer, perpetrator, or innocent civilians. Recently, the advent of robotic systems has enable law enforcement agencies to perform many of the most dangerous aspects of their jobs from relative safety. This is especially true to bomb disposal units but it is also gaining acceptance in other areas. An area where small, remotely operated machines may prove effective is in local aerial surveillance. Currently, the only aerial surveillance assets generally available to law enforcement agencies are costly helicopters. Unfortunately, most of the recently developed unmanned air vehicles (UAVs) are directed towards military applications and have limited civilian use. Systems Planning and Analysis, Inc. (SPA) has conceived and performed a preliminary analysis of a low-cost, inflatable, lighter- than-air surveillance system that may be used in a number of military and law enforcement surveillance situations. The preliminary analysis includes the concept definition, a detailed trade study to determine the optimal configuration of the surveillance system, high-pressure inflation tests, and a control analysis. This paper will provide the details in these areas of the design and provide an insight into the feasibility of such a system.

Applied learning-based color tone mapping for face recognition in video surveillance system

NASA Astrophysics Data System (ADS)

Yew, Chuu Tian; Suandi, Shahrel Azmin

2012-04-01

In this paper, we present an applied learning-based color tone mapping technique for video surveillance system. This technique can be applied onto both color and grayscale surveillance images. The basic idea is to learn the color or intensity statistics from a training dataset of photorealistic images of the candidates appeared in the surveillance images, and remap the color or intensity of the input image so that the color or intensity statistics match those in the training dataset. It is well known that the difference in commercial surveillance cameras models, and signal processing chipsets used by different manufacturers will cause the color and intensity of the images to differ from one another, thus creating additional challenges for face recognition in video surveillance system. Using Multi-Class Support Vector Machines as the classifier on a publicly available video surveillance camera database, namely SCface database, this approach is validated and compared to the results of using holistic approach on grayscale images. The results show that this technique is suitable to improve the color or intensity quality of video surveillance system for face recognition.

ISS-An Electronic Syndromic Surveillance System for Infectious Disease in Rural China

PubMed Central

Yan, Weirong; Palm, Lars; Lu, Xin; Nie, Shaofa; Xu, Biao; Zhao, Qi; Tao, Tao; Cheng, Liwei; Tan, Li; Dong, Hengjin; Diwan, Vinod K.

2013-01-01

Background syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. Objective this study describes the design and pilot implementation of an electronic surveillance system (ISS) for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. Methods ISS was developed based on an existing platform ‘Crisis Information Sharing Platform’ (CRISP), combining with modern communication and GIS technology. ISS has four interconnected functions: 1) work group and communication group; 2) data source and collection; 3) data visualization; and 4) outbreak detection and alerting. Results As of Jan. 31st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74256, 79701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. Conclusions The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China. PMID:23626853

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

PubMed

Yan, Weirong; Palm, Lars; Lu, Xin; Nie, Shaofa; Xu, Biao; Zhao, Qi; Tao, Tao; Cheng, Liwei; Tan, Li; Dong, Hengjin; Diwan, Vinod K

2013-01-01

Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. This study describes the design and pilot implementation of an electronic surveillance system (ISS) for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP), combining with modern communication and GIS technology. ISS has four interconnected functions: 1) work group and communication group; 2) data source and collection; 3) data visualization; and 4) outbreak detection and alerting. As of Jan. 31(st) 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

Creating a bridge between data collection and program planning: a technical assistance model to maximize the use of HIV/AIDS surveillance and service utilization data for planning purposes.

PubMed

Logan, Jennifer A; Beatty, Maile; Woliver, Renee; Rubinstein, Eric P; Averbach, Abigail R

2005-12-01

Over time, improvements in HIV/AIDS surveillance and service utilization data have increased their usefulness for planning programs, targeting resources, and otherwise informing HIV/AIDS policy. However, community planning groups, service providers, and health department staff often have difficulty in interpreting and applying the wide array of data now available. We describe the development of the Bridging Model, a technical assistance model for overcoming barriers to the use of data for program planning. Through the use of an iterative feedback loop in the model, HIV/AIDS data products constantly are evolving to better inform the decision-making tasks of their multiple users. Implementation of this model has led to improved data quality and data products and to a greater willingness and ability among stakeholders to use the data for planning purposes.

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

PubMed Central

Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Introduction Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings. PMID:27182731

Motion and ranging sensor system for through-the-wall surveillance system

NASA Astrophysics Data System (ADS)

Black, Jeffrey D.

2002-08-01

A portable Through-the-Wall Surveillance System is being developed for law enforcement, counter-terrorism, and military use. The Motion and Ranging Sensor is a radar that operates in a frequency band that allows for surveillance penetration of most non-metallic walls. Changes in the sensed radar returns are analyzed to detect the human motion that would typically be present during a hostage or barricaded suspect scenario. The system consists of a Sensor Unit, a handheld Remote Display Unit, and an optional laptop computer Command Display Console. All units are battery powered and a wireless link provides command and data communication between units. The Sensor Unit is deployed close to the wall or door through which the surveillance is to occur. After deploying the sensor the operator may move freely as required by the scenario. Up to five Sensor Units may be deployed at a single location. A software upgrade to the Command Display Console is also being developed. This software upgrade will combine the motion detected by multiple Sensor Units and determine and track the location of detected motion in two dimensions.

Surveillance and response systems for elimination of tropical diseases: summary of a thematic series in Infectious Diseases of Poverty.

PubMed

Zhou, Xia; Yap, Peiling; Tanner, Marcel; Bergquist, Robert; Utzinger, Jürg; Zhou, Xiao-Nong

2016-05-14

The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with, and disseminate in an open-access format, science outside traditional disciplinary boundaries. The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases. Overall, 22 contributions covering a broad array of diseases are featured - i.e. clonorchiasis, dengue, hepatitis, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), H7N9 avian influenza, lymphatic filariasis, malaria, Middle East respiratory syndrome (MERS), rabies, schistosomiasis and tuberculosis (TB). There are five scoping reviews, a commentary, a letter to the editor, an opinion piece and an editorial pertaining to the theme "Elimination of tropical disease through surveillance and response". The remaining 13 articles are original contributions mainly covering (i) drug resistance; (ii) innovation and validation in the field of mathematical modelling; (iii) elimination of infectious diseases; and (iv) social media reports on disease outbreak notifications released by national health authorities. Analysis of the authors' affiliations reveals that scientists from the People's Republic of China (P.R. China) are prominently represented. Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases (NIPD) in Shanghai, coupled with P.R. China's growing importance with regard to the control of infectious diseases. Within 4 to 22 months of publication, three of the 22 contributions were viewed more than 10 000 times each. With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases, Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond.

New Human Immunodeficiency Virus diagnoses among Men Who Have Sex with Men attending STD clinics, STD Surveillance Network, January 2010 to June 2013.

PubMed

Llata, Eloisa; Braxton, Jim; Asbel, Lenore; Kerani, Roxanne P; Murphy, Ryan; Pugsley, River; Pathela, Preeti; Schumacher, Christina; Tabidze, Irina; Weinstock, Hillard S

2018-02-07

To estimate new HIV diagnosis rates among HIV negative MSM who are repeatedly tested for HIV in sexually transmitted disease (STD) clinics, and assess the impact of demographic and disease-specific characteristics that are associated with higher HIV diagnosis rates. Retrospective analysis using 2010-2013 data from the STD Surveillance Network (SSuN), a sentinel surveillance system comprised of health departments in 12 cities conducting sentinel surveillance in 40 STD clinics. We analyzed data from all MSM repeatedly (≥2 times) tested for HIV, with an initial negative HIV test required for staggered cohort entry. Follow-up time was accrued from the date of the first negative HIV test to the most recent negative test or the first positive HIV test. STD diagnoses during the follow-up period were reviewed. We estimated HIV diagnoses rates (number of HIV diagnoses/total number of person-years at risk) by demographic and clinical characteristics with 95% confidence intervals (CI) using an inverse variance weighted random effects model, adjusting for heterogeneity between SSuN jurisdictions. Overall, 640 HIV diagnoses occurred among 14,824 individuals and 20,951.6 person-years (PY) of observation, for an adjusted incidence of HIV diagnosis of 3.0 per 100 PY (95% CI 2.6, 3.4). Rates varied across race/ethnicity groups with the highest rate among Blacks (4.7/100 PY; 95% CI 4.1-5.3) followed by Hispanics, Whites and persons of other races/ethnicities. MSM having a diagnosis of P&S syphilis on or after the first negative HIV test had a higher new HIV diagnosis rate (7.2/100 PY; 95% CI 5.8-9.0) compared to MSM who did not have a P&S syphilis diagnosis (2.8/100 PY; 95% CI 2.6-3.1). MSM who tested positive for rectal gonorrhea (6.3/100 PY; 95% CI 5.7-6.9) or rectal chlamydia (5.6/100 PY; 95% CI 4.6-6.6) had higher rates of new HIV diagnosis when compared to those with negative test results. MSM attending SSuN STD clinics have high rates of new HIV diagnoses, particularly those

AEGIS: a robust and scalable real-time public health surveillance system.

PubMed

Reis, Ben Y; Kirby, Chaim; Hadden, Lucy E; Olson, Karen; McMurry, Andrew J; Daniel, James B; Mandl, Kenneth D

2007-01-01

In this report, we describe the Automated Epidemiological Geotemporal Integrated Surveillance system (AEGIS), developed for real-time population health monitoring in the state of Massachusetts. AEGIS provides public health personnel with automated near-real-time situational awareness of utilization patterns at participating healthcare institutions, supporting surveillance of bioterrorism and naturally occurring outbreaks. As real-time public health surveillance systems become integrated into regional and national surveillance initiatives, the challenges of scalability, robustness, and data security become increasingly prominent. A modular and fault tolerant design helps AEGIS achieve scalability and robustness, while a distributed storage model with local autonomy helps to minimize risk of unauthorized disclosure. The report includes a description of the evolution of the design over time in response to the challenges of a regional and national integration environment.

Seroprevalence of Herpes Simplex Virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti.

PubMed

Domercant, Jean Wysler; Jean Louis, Frantz; Hulland, Erin; Griswold, Mark; Andre-Alboth, Jocelyne; Ye, Tun; Marston, Barbara J

2017-08-18

Herpes simplex virus type 2 (HSV-2), one the most common causes of genital ulcers, appears to increase both the risk of HIV acquisition and HIV transmission. HSV-2/HIV co-infection among pregnant women may increase the risk of perinatal transmission of HIV. This study describes rates of HSV-2 among pregnant women in Haiti and HSV-2 test performance in this population. Unlinked residual serum specimens from the 2012 National HIV and Syphilis Sentinel Surveillance Survey among pregnant women in Haiti were tested using two commercial kits (Focus HerpeSelect, Kalon) for HSV-2 antibodies. We evaluated rates of HSV-2 seropositivity and HSV-2/HIV co-infection, associations between HSV-2 and demographic characteristics using multivariable Cox proportional hazards modeling, and HSV-2 test performance in this population. Serum samples from 1000 pregnant women (all 164 HIV positive and 836 random HIV negative) were selected. The overall weighted prevalence of HSV-2 was 31.4% (95% CI: 27.7-35.4) and the prevalence of HIV-positivity among HSV-2 positive pregnant women was five times higher than the prevalence among HSV-2 negative women (4.8% [95% CI: 3.9-6.0] vs. 0.9% [95% CI: 0.6-1.3], respectively). Factors significantly associated with HSV-2 positivity were HIV-positivity (PR: 2.27 [95% CI: 1.94-2.65]) and older age (PRs: 1.41 [95% CI: 1.05-1.91] for 20-24 years, 1.71 [95% CI:1.13-2.60] for 30-34 years, and 1.55 [95% CI: 1.10-2.19] for 35 years or greater]), while rural residence was negatively associated with HSV-2 positivity (PR 0.83 [95% CI: 0.69-1.00]), after controlling for other covariables. For this study a conservative Focus index cutoff of 3.5 was used, but among samples with a Focus index value ≥2.5, 98.4% had positive Kalon tests. The prevalence of HSV-2 is relatively high among pregnant women in Haiti. Public health interventions to increase access to HSV-2 screening in antenatal services are warranted.

Epidemiological changes in AIDS and HIV infection in Italy.

PubMed

Suligoi, Barbara; Pezzotti, Patrizio; Boros, Stefano; Urciuoli, Roberta; Rezza, Giovanni

2003-01-01

This article describes the major changes in the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS) epidemic in Italy, using data from the National AIDS Registry and from 5 local surveillance systems for new HIV diagnoses. From 1982 to 2001, 49,063 adults with AIDS were reported to the AIDS Registry. From 1988 to 2000, the 5 local systems reported 23,252 new HIV diagnoses. The AIDS incidence increased until 1995, followed by a progressive decrease. A decrease was also observed for the incidence of new HIV diagnoses after 1989, with an apparent stabilization after 1998. Most AIDS cases have been represented by intravenous drug users (IDU), yet since 1999 the percentage of cases attributable to sexual transmission has exceeded that for IDUs. Similarly, among new HIV diagnoses, the percentage of cases attributable to sexual transmission increased from 23.6% before 1993 to 58.5% in 2000. The percentage of people with AIDS who discovered their seropositivity no earlier than 6 months before AIDS diagnosis increased from 20.6% in 1996 to 48.8% in 2001. Although the incidence of both AIDS and new HIV diagnoses has declined, a possible resurgence of the epidemic cannot be ruled out, in light of various factors that could lead to an increasing number of living infected people.

HIV Infection and Linkage to HIV-Related Medical Care in Large Urban Areas in the United States, 2009.

PubMed

Laffoon, Benjamin T; Hall, H Irene; Surendera Babu, Aruna; Benbow, Nanette; Hsu, Ling C; Hu, Yunyin W

2015-08-01

Residents of urban areas have accounted for the majority of persons diagnosed with HIV disease in the United States. Linking persons recently diagnosed with HIV to primary medical care is an important indicator in the National HIV/AIDS Strategy. We analyzed data reported to the HIV Surveillance System in 18 urban areas in the United States. Standardized executable SAS programs were distributed to determine the number of HIV cases living through 2008, number of HIV cases diagnosed in 2009, and the percentage of those diagnosed in 2009 who had reported CD4 lymphocyte or HIV viral load test results within 3 months of HIV diagnosis. Data were presented by jurisdiction, age group at diagnosis, race/ethnicity, sex at birth, birth country, disease stage, and transmission category. By jurisdiction, the percentage of persons diagnosed in 2009 with at least 1 CD4 or HIV viral load test within 3 months of diagnosis ranged from 48.5% to 92.5% (median: 70.9). The percentage of persons linked to care varied by age group and by racial/ethnic groups. Fourteen of the 18 areas reported that the percentage of persons linked to care was greater than 65%, the baseline measure indicated in the National HIV/AIDS Strategy. A wide range in percent linked to HIV medical care was observed between residents of 18 urban areas in the United States with noted age and racial disparities. Routine testing and linkage efforts and intensified prevention efforts should be considered to increase access to primary HIV-related medical care.

Epidemiology of HIV/AIDS among non-Hispanic black women in the United States.

PubMed Central

Whitmore, Suzanne K.; Satcher, Anna J.; Hu, Sherry

2005-01-01

BACKGROUND: HIV/AIDS has emerged as a persistent health threat to black women in the United States. For the past decade, HIV disease has been among the top 10 leading causes of death for this population. METHODS: We analyzed national HIV surveillance data from 29 states with confidential name-based HIV infection reporting that have conducted integrated HIV/AIDS surveillance since at least 1998. We also analyzed AIDS surveillance data from all 50 states and the District of Columbia. RESULTS: In 2002, black women represented 14% of all women in the 29 states whose HIV data were analyzed but 72.3% of annual HIV infection diagnoses among women. In that same year, black women were diagnosed with HIV infection at a rate of 68.7 per 100,000, approximately 23 times the rate for white women (three per 100,000) and four times that for Hispanic women (17.2 per 100,000). Likewise, in 2002, black women represented 13% of all women in the 50 states and the District of Columbia but an estimated 67.8% of new AIDS diagnoses among women. In that same year, black women were diagnosed with AIDS at a rate of 48 per 100,000, approximately 23 times the rate for white women (2.1 per 100,000) and more than four times that for Hispanic women (10.6 per 100,000), CONCLUSIONS: Because black women are disproportionately affected by HIV/AIDS, effective strategies are needed to prevent new HIV infections, to detect HIV infections early and to assure adequate treatment for black women who are infected with HIV. PMID:16080453

Alcohol and HIV Effects on the Immune System.

PubMed

Bagby, Gregory J; Amedee, Angela M; Siggins, Robert W; Molina, Patricia E; Nelson, Steve; Veazey, Ronald S

2015-01-01

HIV disease and alcohol independently influence the human immune system, so it stands to reason that, together, their influence may be additive. Here, we review the evidence that alcohol can exacerbate HIV's influence on the immune system, thereby affecting disease progression and transmission. We focus particularly on alcohol's effect on the mucosal immune system in the tissues of the gastrointestinal tract, the genital tract and the lungs, all of which play a role in transmission and progression of HIV disease.

Was the French clinical surveillance system of bovine brucellosis influenced by the occurrence and surveillance of other abortive diseases?

PubMed

Bronner, Anne; Morignat, Eric; Touratier, Anne; Gache, Kristel; Sala, Carole; Calavas, Didier

2015-03-01

The bovine brucellosis clinical surveillance system implemented in France aims to detect early any case of bovine brucellosis, a disease of which the country has been declared free since 2005. It relies on the mandatory notification of every bovine abortion. Following the spread of the Schmallenberg virus (SBV) in France in 2012 and 2013, and the implementation in 2012 of a clinical surveillance programme of Q fever based on abortion notifications in ten pilot départements, our objective was to study whether these two events influenced the brucellosis clinical surveillance system. The proportion of notifying farmers was analyzed over each semester from June 1, 2009 to June 30, 2013 according to the size and production type of herds, SBV status of départements and the implementation of the Q fever surveillance. Our analysis showed a slight increase in the proportion of notifying farmers as départements became infected by SBV, and after the implementation of Q fever surveillance (during the first semester of 2013). These variations might be explained by an increase in abortion occurrence (congenital deformities in newborns, due to SBV) and/or by an increase in farmers' and veterinarians' awareness (due to the spread of SBV and the implementation of the Q fever surveillance). These results highlight the difficulties in interpreting variations in the proportion of notifying farmers as a consequence of an increase in abortion occurrence. As bovine abortion surveillance can play an important role in the early warning for several diseases, there is a need to explore other ways to monitor abortions in cattle, such as syndromic surveillance using the dates of artificial insemination or calving data. Copyright © 2015 Elsevier B.V. All rights reserved.

Decoding noises in HIV computational genotyping.

PubMed

Jia, MingRui; Shaw, Timothy; Zhang, Xing; Liu, Dong; Shen, Ye; Ezeamama, Amara E; Yang, Chunfu; Zhang, Ming

2017-11-01

Lack of a consistent and reliable genotyping system can critically impede HIV genomic research on pathogenesis, fitness, virulence, drug resistance, and genomic-based healthcare and treatment. At present, mis-genotyping, i.e., background noises in molecular genotyping, and its impact on epidemic surveillance is unknown. For the first time, we present a comprehensive assessment of HIV genotyping quality. HIV sequence data were retrieved from worldwide published records, and subjected to a systematic genotyping assessment pipeline. Results showed that mis-genotyped cases occurred at 4.6% globally, with some regional and high-risk population heterogeneities. Results also revealed a consistent mis-genotyping pattern in gp120 in all studied populations except the group of men who have sex with men. Our study also suggests novel virus diversities in the mis-genotyped cases. Finally, this study reemphasizes the importance of implementing a standardized genotyping pipeline to avoid genotyping disparity and to advance our understanding of virus evolution in various epidemiological settings. Copyright © 2017 Elsevier Inc. All rights reserved.

Infectious Disease Surveillance in the Big Data Era: Towards Faster and Locally Relevant Systems

PubMed Central

Simonsen, Lone; Gog, Julia R.; Olson, Don; Viboud, Cécile

2016-01-01

While big data have proven immensely useful in fields such as marketing and earth sciences, public health is still relying on more traditional surveillance systems and awaiting the fruits of a big data revolution. A new generation of big data surveillance systems is needed to achieve rapid, flexible, and local tracking of infectious diseases, especially for emerging pathogens. In this opinion piece, we reflect on the long and distinguished history of disease surveillance and discuss recent developments related to use of big data. We start with a brief review of traditional systems relying on clinical and laboratory reports. We then examine how large-volume medical claims data can, with great spatiotemporal resolution, help elucidate local disease patterns. Finally, we review efforts to develop surveillance systems based on digital and social data streams, including the recent rise and fall of Google Flu Trends. We conclude by advocating for increased use of hybrid systems combining information from traditional surveillance and big data sources, which seems the most promising option moving forward. Throughout the article, we use influenza as an exemplar of an emerging and reemerging infection which has traditionally been considered a model system for surveillance and modeling. PMID:28830112

Sensitivity of the Dengue Surveillance System in Brazil for Detecting Hospitalized Cases

PubMed Central

2016-01-01

We evaluated the sensitivity of the dengue surveillance system in detecting hospitalized cases in ten capital cities in Brazil from 2008 to 2013 using a probabilistic record linkage of two independent information systems hospitalization (SIH-SUS) adopted as the gold standard and surveillance (SINAN). Sensitivity was defined as the proportion of cases reported to the surveillance system amid the suspected hospitalized cases registered in SIH-SUS. Of the 48,174 hospitalizations registered in SIH-SUS, 24,469 (50.7%) were reported and registered in SINAN, indicating an overall sensitivity of 50.8% (95%CI 50.3–51.2). The observed sensitivity for each of the municipalities included in the study ranged from 22.0% to 99.1%. The combination of the two data sources identified 71,161 hospitalizations, an increase of 97.0% over SINAN itself. Our results allowed establishing the proportion of underreported dengue hospitalizations in the public health system in Brazil, highlighting the use of probabilistic record linkage as a valuable tool for evaluating surveillance systems. PMID:27192405

HIV-1 drug resistance surveillance in antiretroviral treatment-naive individuals from a reference hospital in Guatemala, 2010-2013.

PubMed

Avila-Ríos, Santiago; García-Morales, Claudia; Garrido-Rodríguez, Daniela; Tapia-Trejo, Daniela; Girón-Callejas, Amalia Carolina; Mendizábal-Burastero, Ricardo; Escobar-Urias, Ingrid Yessenia; García-González, Blanca Leticia; Navas-Castillo, Sabrina; Pinzón-Meza, Rodolfo; Mejía-Villatoro, Carlos Rodolfo; Reyes-Terán, Gustavo

2015-04-01

The recent expansion of antiretroviral treatment (ART) coverage in middle/low-income countries has been associated with increasing prevalence of HIV pre-ART drug resistance (PDR). We assessed PDR prevalence, patterns, and trends in Guatemala. Blood samples from 1,084 ART-naive individuals, enrolled from October 2010 to December 2013 at the Roosevelt Hospital in Guatemala City, were obtained. PDR was evaluated using the WHO mutation list for transmitted drug resistance (TDR) surveillance. An overall PDR prevalence of 7.3% (95% CI 5.8-9.0%) was observed for the whole study period. TDR to nonnucleoside reverse transcriptase inhibitors (NNRTI) was the highest (4.9%, p<0.001), followed by nucleoside RT inhibitors (1.8%) and protease inhibitors (1.0%). No significant trends in PDR prevalence were observed during the study period. However, higher NNRTI PDR levels were found in individuals with >500 and 350-500 CD4(+) T cells/μl (7.4% and 8.7%, respectively) compared to individuals with <350 CD4(+) T cells/μl (3.7%; p=0.039 and p=0.007, respectively), as well as a tendency of higher levels of NNRTI transmitted drug resistance (DR) in individuals with recent infection determined by HIV incidence tests (9.7%), suggesting increasing trends in time. Clusters of viruses with NNRTI PDR suggesting complex transmission networks were observed. No associations between PDR and demographic variables were found. PDR in Guatemala remains at an intermediate level. Nevertheless, we have shown evidence suggesting increasing trends in NNRTI PDR, which need to be taken into account in national HIV management policies.

Using the Baidu Search Index to Predict the Incidence of HIV/AIDS in China.

PubMed

He, Guangye; Chen, Yunsong; Chen, Buwei; Wang, Hao; Shen, Li; Liu, Liu; Suolang, Deji; Zhang, Boyang; Ju, Guodong; Zhang, Liangliang; Du, Sijia; Jiang, Xiangxue; Pan, Yu; Min, Zuntao

2018-06-13

Based on a panel of 30 provinces and a timeframe from January 2009 to December 2013, we estimate the association between monthly human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) incidence and the relevant Internet search query volumes in Baidu, the most widely used search engine among the Chinese. The pooled mean group (PMG) model show that the Baidu search index (BSI) positively predicts the increase in HIV/AIDS incidence, with a 1% increase in BSI associated with a 2.1% increase in HIV/AIDS incidence on average. This study proposes a promising method to estimate and forecast the incidence of HIV/AIDS, a type of infectious disease that is culturally sensitive and highly unevenly distributed in China; the method can be taken as a complement to a traditional HIV/AIDS surveillance system.

A Pilot Study to Increase the Efficiency of HIV Outreach Testing Through the Use of Timely and Geolocated HIV Viral Load Surveillance Data

PubMed Central

Jennings, Jacky M.; Schumacher, Christina; Perin, Jamie; Myers, Tanya; Fields, Nathan; Greiner Safi, Amelia; Chaulk, Patrick

2018-01-01

Background Eliminating HIV transmission in a population necessitates identifying population reservoirs of HIV infection and subgroups most likely to transmit. HIV viral load is the single most important predictor of HIV transmission. The objective of this analysis was to evaluate whether a public health practice pilot project based on community viral load resulted in increases in the proportion of time spent testing in high viral load areas (process measure) and 3 outcome measures—the number and percent of overall HIV diagnoses, new diagnoses, and high viral load positives—in one mid-Atlantic US city with a severe HIV epidemic. Methods The evaluation was conducted during three, 3-month periods for 3 years and included the use of community viral load, global positioning system tracking data, and statistical testing to evaluate the effectiveness of the pilot project. Results The proportion of time spent outreach testing in high viral load areas (69%–84%, P < 0.001) and the overall number and percent of HIV positives ((60 (3%) to 127 (6%), P < 0.001) significantly increased for 3 years. The number and percent of new diagnoses (3 (0.1%) to 6 (0.2%)) and high viral load positives (5 (0.2%) to 9 (0.4%)) increased, but the numbers were too small for statistical testing. Discussion These results suggest that using community viral load to increase the efficiency of HIV outreach testing is feasible and may be effective in identifying more HIV positives. The pilot project provides a model for other public health practice demonstration projects. PMID:29420450

A review of occupational disease surveillance systems in Modernet countries.

PubMed

Carder, M; Bensefa-Colas, L; Mattioli, S; Noone, P; Stikova, E; Valenty, M; Telle-Lamberton, M

2015-11-01

To improve occupational health public policies and to facilitate coordinated research within the European Union to reduce the incidence of occupational diseases (ODs), it is important to know what OD surveillance systems exist and how they compare. Monitoring trends in occupational diseases and tracing new and emerging risks in a network (Modernet) participants are well placed to provide this information as most either contribute data to and/or are involved in the management of OD systems. To identify and describe OD surveillance systems in Modernet countries with the longer-term objective of identifying a core template to be used on a large scale. A questionnaire sent to Modernet participants, seeking structured information about the OD surveillance system(s) in their country. Overall 14 countries (70%) provided information for 33 OD systems, among them 11 compensation-based (CB) systems. Six countries provided information for non-CB systems reporting for any type of OD. The other systems reported either only ODs from a prescribed list, or specific diagnoses or diagnostic groups, with reports to most schemes being physician-based. Data collected varied but all systems collected diagnosis, age, gender, date reported and occupation (and/or industry) and most collected information on exposure. This review provides information beneficial to both policy makers and researchers by identifying data sources useable to measure OD trends in European countries and opening the way to future work, both on trend comparisons within Europe and on the definition of a core template to extend OD surveillance on a larger scale. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Preferences for Home-Based HIV Testing Among Heterosexuals at Increased Risk for HIV/AIDS: New Orleans, Louisiana, 2013.

PubMed

Robinson, William T; Zarwell, Meagan; Gruber, DeAnn

2017-07-01

Participants in the New Orleans arm of the National HIV Behavioral Surveillance of Heterosexuals at Increased Risk for HIV were asked about potential utilization of self-administered home-based tests for HIV. The majority (86%) would use a free home-based test if provided by mail and 99% would seek treatment based on a positive result. In addition, more than half of respondents would return test results in some format to the test provider, whereas most of the remaining participants preferred to discuss results only with their doctor. These findings point toward a potential method for advancing the National HIV/AIDS Strategy.

Viral immune surveillance: Toward a TH17/TH9 gate to the central nervous system.

PubMed

Barkhordarian, Andre; Thames, April D; Du, Angela M; Jan, Allison L; Nahcivan, Melissa; Nguyen, Mia T; Sama, Nateli; Chiappelli, Francesco

2015-01-01

Viral cellular immune surveillance is a dynamic and fluid system that is driven by finely regulated cellular processes including cytokines and other factors locally in the microenvironment and systemically throughout the body. It is questionable as to what extent the central nervous system (CNS) is an immune-privileged organ protected by the blood-brain barrier (BBB). Recent evidence suggests converging pathways through which viral infection, and its associated immune surveillance processes, may alter the integrity of the blood-brain barrier, and lead to inflammation, swelling of the brain parenchyma and associated neurological syndromes. Here, we expand upon the recent "gateway theory", by which viral infection and other immune activation states may disrupt the specialized tight junctions of the BBB endothelium making it permeable to immune cells and factors. The model we outline here builds upon the proposition that this process may actually be initiated by cytokines of the IL-17 family, and recognizing the intimate balance between TH17 and TH9 cytokine profiles systemically. We argue that immune surveillance events, in response to viruses such as the Human Immunodeficiency Virus (HIV), cause a TH17/TH9 induced gateway through blood brain barrier, and thus lead to characteristic neuroimmune pathology. It is possible and even probable that the novel TH17/TH9 induced gateway, which we describe here, opens as a consequence of any state of immune activation and sustained chronic inflammation, whether associated with viral infection or any other cause of peripheral or central neuroinflammation. This view could lead to new, timely and critical patient-centered therapies for patients with neuroimmune pathologies across a variety of etiologies. BBB - blood brain barrier, BDV - Borna disease virus, CARD - caspase activation and recruitment domains, CD - clusters of differentiation, CNS - central nervous system, DAMP - damage-associated molecular patterns, DENV - Dengue

Twenty-two years of HIV infection in Bhutan: epidemiological profile.

PubMed

Tshering, Pandup; Lhazeen, Karma; Wangdi, Sonam; Tshering, Namgay

2016-11-28

To describe the HIV epidemiology in Bhutan. Data from the database of people living with HIV infection in Bhutan, survey reports from the National STI and HIV/AIDS Control Programme from the Ministry of Health and published literature on HIV in Bhutan were reviewed. Bhutan continues to have a low HIV prevalence with only 470 cases reported by the end of 2015. However, there is a slow but steady recent increase in the number of cases. The main mode of transmission is unsafe heterosexual practice in the general population and is occurring mostly in urban and business districts. More than half of cases have been diagnosed in only three districts. Although the number of cases among key populations such as sex workers and intravenous drug users remains significantly low, the information available remains very limited. There is only scarce published literature on HIV in Bhutan and an absence of a strategic surveillance system. A high level of sexually transmitted infections and multiple sexual relationships represent the existing threats that may fuel a larger epidemic. Bhutan has a maintained a low HIV prevalence over the past two decades, which is reflected in the national response to HIV. However, with the presence of existing and newly emerging risk factors, this response needs to adapt continually. To ensure that HIV prevalence remains low, it is crucial to invest in a strategic information system to monitor rates of infections to guide the public health response.

Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh.

PubMed

Ao, Trong T; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M Jahangir; Haider, Sabbir; Alamgir, A S M; Sobel, Jeremy; Luby, Stephen P; Gurley, Emily S

2016-04-01

We assessed a media-based public health surveillance system in Bangladesh during 2010-2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005.

The conundrum of harmonizing resistance surveillance systems on a global level

USDA-ARS?s Scientific Manuscript database

Surveillance systems, particularly those involving complex data over time, provide unique challenges. They are as varied in design, intent, funding and function as the countries in which they exist. The Centers for Disease Control and Prevention define surveillance as ‘the ongoing systematic colle...

Testing a symptom-based surveillance system at high-profile gatherings as a preparatory measure for bioterrorism.

PubMed

Osaka, K; Takahashi, H; Ohyama, T

2002-12-01

We tested symptom-based surveillance during the G8 conference in 2000 as a means of detecting outbreaks, including bio-terrorism attacks, promptly. Five categories of symptoms (skin and haemorrhagic, respiratory, gastrointestinal, neurological and unexplained) were adopted for the case definition of the surveillance. The surveillance began I week before the conference, and continued until 1 week after the conference ended. We could not detect any outbreaks during this surveillance. Compared to the existing diagnosis-based surveillance system, symptom-based surveillance has the advantages of timeliness and simplicity. However, poor specificity and difficulties in determining epidemic threshold were important limitations of this system. To increase the specificity of surveillance, it is essential to incorporate rapid laboratory diagnoses into the system.

Description and validation of a new automated surveillance system for Clostridium difficile in Denmark.

PubMed

Chaine, M; Gubbels, S; Voldstedlund, M; Kristensen, B; Nielsen, J; Andersen, L P; Ellermann-Eriksen, S; Engberg, J; Holm, A; Olesen, B; Schønheyder, H C; Østergaard, C; Ethelberg, S; Mølbak, K

2017-09-01

The surveillance of Clostridium difficile (CD) in Denmark consists of laboratory based data from Departments of Clinical Microbiology (DCMs) sent to the National Registry of Enteric Pathogens (NREP). We validated a new surveillance system for CD based on the Danish Microbiology Database (MiBa). MiBa automatically collects microbiological test results from all Danish DCMs. We built an algorithm to identify positive test results for CD recorded in MiBa. A CD case was defined as a person with a positive culture for CD or PCR detection of toxin A and/or B and/or binary toxin. We compared CD cases identified through the MiBa-based surveillance with those reported to NREP and locally in five DCMs representing different Danish regions. During 2010-2014, NREP reported 13 896 CD cases, and the MiBa-based surveillance 21 252 CD cases. There was a 99·9% concordance between the local datasets and the MiBa-based surveillance. Surveillance based on MiBa was superior to the current surveillance system, and the findings show that the number of CD cases in Denmark hitherto has been under-reported. There were only minor differences between local data and the MiBa-based surveillance, showing the completeness and validity of CD data in MiBa. This nationwide electronic system can greatly strengthen surveillance and research in various applications.

Surveillance system and method having an adaptive sequential probability fault detection test

NASA Technical Reports Server (NTRS)

Herzog, James P. (Inventor); Bickford, Randall L. (Inventor)

2005-01-01

System and method providing surveillance of an asset such as a process and/or apparatus by providing training and surveillance procedures that numerically fit a probability density function to an observed residual error signal distribution that is correlative to normal asset operation and then utilizes the fitted probability density function in a dynamic statistical hypothesis test for providing improved asset surveillance.

Surveillance system and method having an adaptive sequential probability fault detection test

NASA Technical Reports Server (NTRS)

Bickford, Randall L. (Inventor); Herzog, James P. (Inventor)

2006-01-01

System and method providing surveillance of an asset such as a process and/or apparatus by providing training and surveillance procedures that numerically fit a probability density function to an observed residual error signal distribution that is correlative to normal asset operation and then utilizes the fitted probability density function in a dynamic statistical hypothesis test for providing improved asset surveillance.

Surveillance System and Method having an Adaptive Sequential Probability Fault Detection Test

NASA Technical Reports Server (NTRS)

Bickford, Randall L. (Inventor); Herzog, James P. (Inventor)

2008-01-01

System and method providing surveillance of an asset such as a process and/or apparatus by providing training and surveillance procedures that numerically fit a probability density function to an observed residual error signal distribution that is correlative to normal asset operation and then utilizes the fitted probability density function in a dynamic statistical hypothesis test for providing improved asset surveillance.

Comparison of Individual and Area Level Factors Between HIV-Infected Cisgender and Transgender Individuals in Florida (2006-2014).

PubMed

Fennie, K P; Trepka, M J; Maddox, L M; Lutfi, K; Lieb, S

2016-10-01

This descriptive study compares individual- and area-level factors among HIV-infected transgender and cisgender individuals in Florida using data from the Florida Department of Health HIV/AIDS surveillance system (2006-2014). Of those individuals diagnosed with HIV, 7 (0.01 %) identified as transgender males, 142 (0.3 %) as transgender females, 12,497 (25.7 %) as cisgender females, and 35,936 (74.0 %) as cisgender males. Transgender females resided in rural and urban areas, were disproportionately non-Hispanic black, and were more likely than cisgender women to be diagnosed with AIDS within 3 months of their HIV diagnosis. Results suggest HIV screening and outreach efforts should be enhanced for transgender women.

New York governor signs bill to track HIV cases by name.

PubMed

1998-07-24

Senate Bill 4422-B, a partner notification bill that uses name-based reporting to track HIV cases, was signed by New York Governor George Pataki on July 7, 1998. The new legislation requires physicians to report the names of all HIV-positive patients to the State Department of Health so that public officials can notify spouses, sexual partners, and needle-sharing partners of possible exposure. This information will become part of a State-wide case surveillance system. Patient advocacy and civil liberties groups did not support the bill, stating that it would erode the physician-patient relationship by breaching confidentiality. The new legislation does not apply to anonymous testing sites, although once individuals begin HIV-related medical treatment, their name will be sent to the State.

A comparison of four sampling methods among men having sex with men in China: implications for HIV/STD surveillance and prevention

PubMed Central

Guo, Yan; Li, Xiaoming; Fang, Xiaoyi; Lin, Xiuyun; Song, Yan; Jiang, Shuling; Stanton, Bonita

2011-01-01

Sample representativeness remains one of the challenges in effective HIV/STD surveillance and prevention targeting MSM worldwide. Although convenience samples are widely used in studies of MSM, previous studies suggested that these samples might not be representative of the broader MSM population. This issue becomes even more critical in many developing countries where needed resources for conducting probability sampling are limited. We examined variations in HIV and Syphilis infections and sociodemographic and behavioral factors among 307 young migrant MSM recruited using four different convenience sampling methods (peer outreach, informal social network, Internet, and venue-based) in Beijing, China in 2009. The participants completed a self-administered survey and provided blood specimens for HIV/STD testing. Among the four MSM samples using different recruitment methods, rates of HIV infections were 5.1%, 5.8%, 7.8%, and 3.4%; rates of Syphilis infection were 21.8%, 36.2%, 11.8%, and 13.8%; rates of inconsistent condom use were 57%, 52%, 58%, and 38%. Significant differences were found in various sociodemographic characteristics (e.g., age, migration history, education, income, places of employment) and risk behaviors (e.g., age at first sex, number of sex partners, involvement in commercial sex, and substance use) among samples recruited by different sampling methods. The results confirmed the challenges of obtaining representative MSM samples and underscored the importance of using multiple sampling methods to reach MSM from diverse backgrounds and in different social segments and to improve the representativeness of the MSM samples when the use of probability sampling approach is not feasible. PMID:21711162

HIV-1 functional cure: will the dream come true?

PubMed

Liu, Chao; Ma, Xiancai; Liu, Bingfeng; Chen, Cancan; Zhang, Hui

2015-11-20

The reservoir of human immunodeficiency virus type 1 (HIV-1), a long-lived pool of latently infected cells harboring replication-competent viruses, is the major obstacle to curing acquired immune deficiency syndrome (AIDS). Although the combination antiretroviral therapy (cART) can successfully suppress HIV-1 viremia and significantly delay the progression of the disease, it cannot eliminate the viral reservoir and the patient must continue to take anti-viral medicines for life. Currently, the appearance of the 'Berlin patient', the 'Boston patients', and the 'Mississippi baby' have inspired many therapeutic strategies for HIV-1 aimed at curing efforts. However, the specific eradication of viral latency and the recovery and optimization of the HIV-1-specific immune surveillance are major challenges to achieving such a cure. Here, we summarize recent studies addressing the mechanisms underlying the viral latency and define two categories of viral reservoir: 'shallow' and 'deep'. We also present the current strategies and recent advances in the development of a functional cure for HIV-1, focusing on full/partial replacement of the immune system, 'shock and kill', and 'permanent silencing' approaches.

Evaluation of the Measles Surveillance System in Kaduna State, Nigeria (2010-2012).

PubMed

Ameh, Celestine A; Sufiyan, Muawiyyah B; Jacob, Matthew; Waziri, Ndadilnasiya E; Olayinka, Adebola T

2016-01-01

To evaluate the case-based measles surveillance system in Kaduna State of Nigeria and identify gaps in its operation. In Africa, approximately 13 million cases, 650,000 deaths due to measles occur annually, with sub-Saharan Africa having the highest morbidity and mortality. Measles infection is endemic in Nigeria and has been documented to occur all year round, despite high measles routine and supplemental immunization coverage. The frequent outbreaks of measles in Kaduna State prompted the need for the evaluation of the measles case-based surveillance system. We interviewed stakeholders and conducted a retrospective record review of the measles case-based surveillance data from 2010 - 2012 and adapted the 2001 CDC guidelines on surveillance evaluation and the Framework for Evaluating Public Health Surveillance Systems for Early Detection of Outbreaks, to assess the systems usefulness, representativeness, timeliness, stability, acceptability and data quality. We calculated the annualized detection rate of measles and non-measles febrile rash, proportion of available results, proportion of LGAs (Districts) that investigated at least one case with blood, proportion of cases that were IgM positive and the incidence of measles. We compared the results with WHO(2004) recommended performance indicators to determine the quality and effectiveness of measles surveillance system. According to the Stakeholders, the case-based surveillance system was useful and acceptable. Median interval between specimen collection and release of result was 7days (1 - 25 days) in 2010, 38 days (Range: 16 - 109 days) in 2011 and 11 days (Range: 1 - 105 days) in 2012. The annualized detection rate of measles rash in 2010 was 2.1 (target: 3 2), 1.0 (target: 3 2) in 2011 and 1.4 (target: 3 2) in 2012. The annualized detection rate of non-measles febrile rash in 2010 was 2.1 (target: 3 2), 0.6 (target: 3 2) in 2011 and 0.8 (target: 3 2) in 2012. Case definitions are simple and understood by all

An intelligent crowdsourcing system for forensic analysis of surveillance video

NASA Astrophysics Data System (ADS)

Tahboub, Khalid; Gadgil, Neeraj; Ribera, Javier; Delgado, Blanca; Delp, Edward J.

2015-03-01

Video surveillance systems are of a great value for public safety. With an exponential increase in the number of cameras, videos obtained from surveillance systems are often archived for forensic purposes. Many automatic methods have been proposed to do video analytics such as anomaly detection and human activity recognition. However, such methods face significant challenges due to object occlusions, shadows and scene illumination changes. In recent years, crowdsourcing has become an effective tool that utilizes human intelligence to perform tasks that are challenging for machines. In this paper, we present an intelligent crowdsourcing system for forensic analysis of surveillance video that includes the video recorded as a part of search and rescue missions and large-scale investigation tasks. We describe a method to enhance crowdsourcing by incorporating human detection, re-identification and tracking. At the core of our system, we use a hierarchal pyramid model to distinguish the crowd members based on their ability, experience and performance record. Our proposed system operates in an autonomous fashion and produces a final output of the crowdsourcing analysis consisting of a set of video segments detailing the events of interest as one storyline.

A web-based video annotation system for crowdsourcing surveillance videos

NASA Astrophysics Data System (ADS)

Gadgil, Neeraj J.; Tahboub, Khalid; Kirsh, David; Delp, Edward J.

2014-03-01

Video surveillance systems are of a great value to prevent threats and identify/investigate criminal activities. Manual analysis of a huge amount of video data from several cameras over a long period of time often becomes impracticable. The use of automatic detection methods can be challenging when the video contains many objects with complex motion and occlusions. Crowdsourcing has been proposed as an effective method for utilizing human intelligence to perform several tasks. Our system provides a platform for the annotation of surveillance video in an organized and controlled way. One can monitor a surveillance system using a set of tools such as training modules, roles and labels, task management. This system can be used in a real-time streaming mode to detect any potential threats or as an investigative tool to analyze past events. Annotators can annotate video contents assigned to them for suspicious activity or criminal acts. First responders are then able to view the collective annotations and receive email alerts about a newly reported incident. They can also keep track of the annotators' training performance, manage their activities and reward their success. By providing this system, the process of video analysis is made more efficient.

Surveillance of traumatic firefighter fatalities: an assessment of four systems.

PubMed

Estes, Chris R; Marsh, Suzanne M; Castillo, Dawn N

2011-01-01

Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures. We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003-2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods. Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers. The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts.

High HIV Burden in Men Who Have Sex with Men across Colombia’s Largest Cities: Findings from an Integrated Biological and Behavioral Surveillance Study

PubMed Central

Rubio Mendoza, Martha Lucía; Jacobson, Jerry Owen; Morales-Miranda, Sonia; Sierra Alarcón, Clara Ángela; Luque Núñez, Ricardo

2015-01-01

Background Among Latin America’s concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region’s third largest country. To date, surveillance studies have been limited to Bogota, while 80% of HIV cases and deaths originate from Colombia’s other cities and departments. The extent to which interventions should prioritize MSM outside of Bogota is unknown. Methods We recruited 2603 MSM using respondent-driven sampling from seven of Colombia’s largest cities. HIV prevalence was estimated by site from dried blood spot samples. Behavioral data were collected through face-to-face interviews and risk factors for HIV infection analyzed using weighted, multi-level logistical regression models accounting for recruitment patterns. Results Across cities, HIV prevalence averaged 15%, varied from 6% to 24% and was highest in Cali, Bogota, and Barranquilla. In the past 12 months, 65% of MSM had ≥ 5 casual male partners and 23% had a female partner. Across partnerships (i.e., casual, stable, and commercial), the proportion of MSM engaging in unprotected sex was ≥ 52% with male partners and ≥ 66% with female partners. Self-reported history of STI (24%) and past-year illicit drug use (38%) were also common. In multivariate analysis, age ≥ 35 (adjusted odds ratio [AOR], 19.2) and 25–39 (AOR, 5.6) relative to ≤ 18–24 years, identifying as homosexual relative to heterosexual (AOR 0.1), meeting casual partners on the Internet (adjusted odds ratio [AOR], 3.1) and age of sexual debut of ≤ 13 years (AOR, 3.1) predicted HIV infection. HIV testing and prevention messaging reached just 24% of MSM in the past year. Conclusions Findings support consistently elevated HIV burden among MSM throughout Colombia’s largest cities and a need for enhanced behavioral prevention and HIV testing, emphasizing men who use the Internet as well as physical venues to meet sex partners. PMID:26252496

Cost analysis of an integrated vaccine-preventable disease surveillance system in Costa Rica✩

PubMed Central

Toscano, C.M.; Vijayaraghavan, M.; Salazar-Bolaños, H.M.; Bolaños-Acuña, H.M.; Ruiz-González, A.I.; Barrantes-Solis, T.; Fernández-Vargas, I.; Panero, M.S.; de Oliveira, L.H.; Hyde, T.B.

2015-01-01

Introduction Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. Objectives We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. Methods We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. Results During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Conclusions Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and

Cost analysis of an integrated vaccine-preventable disease surveillance system in Costa Rica.

PubMed

Toscano, C M; Vijayaraghavan, M; Salazar-Bolaños, H M; Bolaños-Acuña, H M; Ruiz-González, A I; Barrantes-Solis, T; Fernández-Vargas, I; Panero, M S; de Oliveira, L H; Hyde, T B

2013-07-02

Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and investigation. Our findings will be valuable for

Methodological quality of the injury surveillance system used in international athletics championships.

PubMed

Edouard, Pascal; Branco, Pedro; Alonso, Juan Manuel; Junge, Astrid

2016-12-01

Incidence and prevalence data obtained from injury surveillance studies could be biased by the response rate as well as by the completeness and quality of the reports. It therefore appears crucial to analyse the quality of the injury surveillance system itself and thereby validate the quality of the data. This study aimed to analyse the quality of and compliance with the injury surveillance system implemented during international athletics championships. Prospective, epidemiological study. The national medical teams and the local organising committee physicians daily reported all injuries on a standardised injury report form during 14 international athletics championships from 2007 to 2015. The quality of the injury surveillance system was analysed following the guidelines laid down by the Centre for Disease Control and Prevention. On average 41.7±17.4% (mean±standard deviation) of all registered countries participated in the injury surveillance project, accounting for a coverage of athletes of 79.5±10.2% of all registered athletes. Their medical staff returned 89.2±8.4% of the expected injury report forms (information is missing for one championship). The completeness of injury data provided by medical teams and local organising committee physicians averaged 95.8±6.5%. National medical teams reported 60.6±16.6% of all injuries, and local organising committee physicians 28.7±15.0% whereas 10.6±6.5% of injuries were reported by both. The injury surveillance system used during international athletics championships provided good national medical team participation, coverage of athletes, response rate, and completeness of reports. These parameters should be systematically reported for injury surveillance studies to show the quality of the study. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Evaluation of Syndromic Surveillance Systems in 6 US State and Local Health Departments.

PubMed

Thomas, Mathew J; Yoon, Paula W; Collins, James M; Davidson, Arthur J; Mac Kenzie, William R

Evaluating public health surveillance systems is critical to ensuring that conditions of public health importance are appropriately monitored. Our objectives were to qualitatively evaluate 6 state and local health departments that were early adopters of syndromic surveillance in order to (1) understand the characteristics and current uses, (2) identify the most and least useful syndromes to monitor, (3) gauge the utility for early warning and outbreak detection, and (4) assess how syndromic surveillance impacted their daily decision making. We adapted evaluation guidelines from the Centers for Disease Control and Prevention and gathered input from the Centers for Disease Control and Prevention subject matter experts in public health surveillance to develop a questionnaire. We interviewed staff members from a convenience sample of 6 local and state health departments with syndromic surveillance programs that had been in operation for more than 10 years. Three of the 6 interviewees provided an example of using syndromic surveillance to identify an outbreak (ie, cluster of foodborne illness in 1 jurisdiction) or detect a surge in cases for seasonal conditions (eg, influenza in 2 jurisdictions) prior to traditional, disease-specific systems. Although all interviewees noted that syndromic surveillance has not been routinely useful or efficient for early outbreak detection or case finding in their jurisdictions, all agreed that the information can be used to improve their understanding of dynamic disease control environments and conditions (eg, situational awareness) in their communities. In the jurisdictions studied, syndromic surveillance may be useful for monitoring the spread and intensity of large outbreaks of disease, especially influenza; enhancing public health awareness of mass gatherings and natural disasters; and assessing new, otherwise unmonitored conditions when real-time alternatives are unavailable. Future studies should explore opportunities to

Safety of the pentavalent rotavirus vaccine (PRV), RotaTeq(®), in Kenya, including among HIV-infected and HIV-exposed infants.

PubMed

Laserson, Kayla F; Nyakundi, Daveline; Feikin, Daniel R; Nyambane, Geoffrey; Cook, Earnest; Oyieko, Janet; Ojwando, Joel; Rivers, Stephen B; Ciarlet, Max; Neuzil, Kathleen M; Breiman, Robert F

2012-04-27

Two multicenter Phase III trials were conducted in five countries from March 2007 to March 2009 to evaluate the safety and efficacy of the pentavalent rotavirus vaccine (PRV), RotaTeq(®), in Africa and Asia. In this report, we evaluate the safety of this vaccine, including among HIV-infected and HIV-exposed infants, in Kenya. 1308 Infants were randomized 1:1 to receive 3 doses of PRV/placebo at approximately 6, 10, and 14 weeks of age. HIV counseling and testing were offered to all participants. A positive PCR result indicated HIV infection; the presence of HIV antibody in PCR-negative children indicated HIV exposure without HIV infection. All serious adverse events (SAE) within 14 days of any dose, and vaccine-related SAEs, intussusception, and deaths occurring at any time during the study, were reported ("SAE surveillance"). In addition, 297 participants were followed for 42 days after any dose for any adverse event (AE), regardless of severity ("intensive safety surveillance"). The safety evaluation was stratified by HIV status. SAEs were reported in 20/649 vaccine recipients (3.1%) and 21/643 placebo recipients (3.3%) within 14 days following vaccination (p = 0.9). The most common SAE in the vaccinated group was pneumonia (1.7%). No individual SAE was significantly more common among vaccine vs. placebo recipients. Seventy-two deaths were reported, 38 (5.9%) and 34 (5.3%) among vaccine and placebo recipients, respectively (p = 0.66). No cases of intussusception were reported. During intensive safety surveillance, 137/147 (93.2%) vaccine recipients and 147/150 (98.0%) placebo recipients experienced one or more AEs (risk ratio = 0.95; 95% CI: 0.91-1.0; p = 0.05). 88.5% of the infants were tested for HIV infection; 21/581 (3.6%) children in the vaccine group and 17/577 (2.9%) in the placebo group were HIV-infected. Among the 37 HIV-infected infants with full safety follow-up, 5/21 (23.8%) vaccine recipients and 2/16 (12.5%) placebo recipients reported an SAE (p

Active surveillance for influenza vaccine adverse events: the integrated vaccine surveillance system.

PubMed

Newes-Adeyi, Gabriella; Greece, Jacey; Bozeman, Sam; Walker, Deborah Klein; Lewis, Faith; Gidudu, Jane

2012-02-01

We conducted a pilot study of the Integrated Vaccine Surveillance System (IVSS), a novel active surveillance system for monitoring influenza vaccine adverse events that could be used in mass vaccination settings. We recruited 605 adult vaccinees from a convenience sample of 12 influenza vaccine clinics conducted by public health departments of two U.S. metropolitan regions. Vaccinees provided daily reports on adverse reactions following immunization (AEFI) using an interactive voice response system (IVR) or the internet for 14 consecutive days following immunization. Followup with nonrespondents was conducted through computer-assisted telephone interviewing (CATI). Data on vaccinee reports were available real-time through a dedicated secure website. 90% (545) of vaccinees made at least one daily report and 49% (299) reported consecutively for the full 14-day period. 58% (315) used internet, 20% (110) IVR, 6% (31) CATI, and 16% (89) used a combination for daily reports. Of the 545 reporters, 339 (62%) reported one or more AEFI, for a total of 594 AEFIs reported. The majority (505 or 85%) of these AEFIs were mild symptoms. It is feasible to develop a system to obtain real-time data on vaccine adverse events. Vaccinees are willing to provide daily reports for a considerable time post vaccination. Offering multiple modes of reporting encourages high response rates. Study findings on AEFIs showed that the IVSS was able to exhibit the emerging safety profile of the 2008 seasonal influenza vaccine. Copyright © 2011 Elsevier Ltd. All rights reserved.

Census Tract Poverty and Racial Disparities in HIV Rates in Milwaukee County, Wisconsin, 2009-2014.

PubMed

Gibson, Crystal; Grande, Katarina; Schumann, Casey; Gasiorowicz, Mari

2018-02-22

Previous work has documented associations between poverty and HIV. Understanding of these relationships at local levels could help target prevention efforts; however, HIV surveillance systems do not capture individual-level poverty measures. We utilized the Public Health Disparities Geocoding Project methods to examine HIV rates by census tract poverty. HIV rates and rate ratios were computed by census tract poverty (< 5.0, 5.0-9.9, 10.0-19.9, > 20.0% of individual below the federal poverty level) for all races and stratified by Black and White race using Poisson regression. We observed higher HIV rates in the highest poverty gradient compared to the lowest poverty gradient for all races combined and among White cases. After adjustment, HIV rates were similar across poverty gradients for all comparisons. Our findings suggest that the association between poverty and HIV may differ by subpopulation, while demonstrating the potential for HIV prevention targeting residents of high poverty areas.

Performance Assessment of a Communicable Disease Surveillance System in Response to the Twin Earthquakes of East Azerbaijan.

PubMed

Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbari Sari, Ali

2015-08-01

Following the twin earthquakes on August 11, 2012, in the East Azerbaijan province of Iran, the provincial health center set up a surveillance system to monitor communicable diseases. This study aimed to assess the performance of this surveillance system. In this quantitative-qualitative study, performance of the communicable diseases surveillance system was assessed by using the updated guidelines of the Centers for Disease Control and Prevention (CDC). Qualitative data were collected through interviews with the surveillance system participants, and quantitative data were obtained from the surveillance system. The surveillance system was useful, simple, representative, timely, and flexible. The data quality, acceptability, and stability of the surveillance system were 65.6%, 10.63%, and 100%, respectively. The sensitivity and positive predictive value were not calculated owing to the absence of a gold standard. The surveillance system satisfactorily met the goals expected for its setup. The data obtained led to the control of communicable diseases in the affected areas. Required interventions based on the incidence of communicable disease were designed and implemented. The results also reassured health authorities and the public. However, data quality and acceptability should be taken into consideration and reviewed for implementation in future disasters.

Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh

PubMed Central

Ao, Trong T.; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M. Jahangir; Haider, Sabbir; Alamgir, A.S.M.; Sobel, Jeremy; Luby, Stephen P.

2016-01-01

We assessed a media-based public health surveillance system in Bangladesh during 2010–2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005. PMID:26981877

Social media and internet-based data in global systems for public health surveillance: a systematic review.

PubMed

Velasco, Edward; Agheneza, Tumacha; Denecke, Kerstin; Kirchner, Göran; Eckmanns, Tim

2014-03-01

The exchange of health information on the Internet has been heralded as an opportunity to improve public health surveillance. In a field that has traditionally relied on an established system of mandatory and voluntary reporting of known infectious diseases by doctors and laboratories to governmental agencies, innovations in social media and so-called user-generated information could lead to faster recognition of cases of infectious disease. More direct access to such data could enable surveillance epidemiologists to detect potential public health threats such as rare, new diseases or early-level warnings for epidemics. But how useful are data from social media and the Internet, and what is the potential to enhance surveillance? The challenges of using these emerging surveillance systems for infectious disease epidemiology, including the specific resources needed, technical requirements, and acceptability to public health practitioners and policymakers, have wide-reaching implications for public health surveillance in the 21st century. This article divides public health surveillance into indicator-based surveillance and event-based surveillance and provides an overview of each. We did an exhaustive review of published articles indexed in the databases PubMed, Scopus, and Scirus between 1990 and 2011 covering contemporary event-based systems for infectious disease surveillance. Our literature review uncovered no event-based surveillance systems currently used in national surveillance programs. While much has been done to develop event-based surveillance, the existing systems have limitations. Accordingly, there is a need for further development of automated technologies that monitor health-related information on the Internet, especially to handle large amounts of data and to prevent information overload. The dissemination to health authorities of new information about health events is not always efficient and could be improved. No comprehensive evaluations show

An End-User Participatory Approach to Collaboratively Refine HIV Care Data, The New York State Experience.

PubMed

Swain, Carol-Ann; Sawicki, Steven; Addison, Diane; Katz, Benjamin; Piersanti, Kelly; Baim-Lance, Abigail; Gordon, Daniel; Anderson, Bridget J; Nash, Denis; Steinbock, Clemens; Agins, Bruce

2018-04-02

Existing data dissemination structures primarily rely on top-down approaches. Unless designed with the end user in mind, this may impair data-driven clinical improvements to Human Immunodeficiency Virus (HIV) prevention and care. In this study, we implemented a data visualization activity to create region-specific data presentations collaboratively with HIV providers, consumers of HIV care, and New York State (NYS) Department of Health AIDS Institute staff for use in local HIV care decision-making. Data from the NYS HIV Surveillance Registry (2009-2013) and HIV care facilities (2010-2015) participating in a Health Resources and Services Administration (HRSA) Systems Linkages and Access to Care project were used. Each data package incorporated visuals for: linkage to HIV care, retention in care and HIV viral suppression. End-users were vocal about their data needs and their capacity to interpret public health data. This experience suggests that data dissemination strategies should incorporate input from the end user to improve comprehension and optimize HIV care.

Bootstrap confidence intervals and bias correction in the estimation of HIV incidence from surveillance data with testing for recent infection.

PubMed

Carnegie, Nicole Bohme

2011-04-15

The incidence of new infections is a key measure of the status of the HIV epidemic, but accurate measurement of incidence is often constrained by limited data. Karon et al. (Statist. Med. 2008; 27:4617–4633) developed a model to estimate the incidence of HIV infection from surveillance data with biologic testing for recent infection for newly diagnosed cases. This method has been implemented by public health departments across the United States and is behind the new national incidence estimates, which are about 40 per cent higher than previous estimates. We show that the delta method approximation given for the variance of the estimator is incomplete, leading to an inflated variance estimate. This contributes to the generation of overly conservative confidence intervals, potentially obscuring important differences between populations. We demonstrate via simulation that an innovative model-based bootstrap method using the specified model for the infection and surveillance process improves confidence interval coverage and adjusts for the bias in the point estimate. Confidence interval coverage is about 94–97 per cent after correction, compared with 96–99 per cent before. The simulated bias in the estimate of incidence ranges from −6.3 to +14.6 per cent under the original model but is consistently under 1 per cent after correction by the model-based bootstrap. In an application to data from King County, Washington in 2007 we observe correction of 7.2 per cent relative bias in the incidence estimate and a 66 per cent reduction in the width of the 95 per cent confidence interval using this method. We provide open-source software to implement the method that can also be extended for alternate models.

Surveillance and Datalink Communication Performance Analysis for Distributed Separation Assurance System Architectures

NASA Technical Reports Server (NTRS)

Chung, William W.; Linse, Dennis J.; Alaverdi, Omeed; Ifarraguerri, Carlos; Seifert, Scott C.; Salvano, Dan; Calender, Dale

2012-01-01

This study investigates the effects of two technical enablers: Automatic Dependent Surveillance - Broadcast (ADS-B) and digital datalink communication, of the Federal Aviation Administration s Next Generation Air Transportation System (NextGen) under two separation assurance (SA) system architectures: ground-based SA and airborne SA, on overall separation assurance performance. Datalink performance such as successful reception probability in both surveillance and communication messages, and surveillance accuracy are examined in various operational conditions. Required SA performance is evaluated as a function of subsystem performance, using availability, continuity, and integrity metrics to establish overall required separation assurance performance, under normal and off-nominal conditions.

Development and Implementation of a Surveillance Network System for Emerging Infectious Diseases in the Caribbean (ARICABA).

PubMed

Kim, Wongyu Lewis; Anneducharme, Chelsea; Bucher, Bernard Jean-Marie Philippe

2011-01-01

Dengue fever, including dengue hemorrhagic fever, has become a re-emerging public health threat in the Caribbean in the absence of a comprehensive regional surveillance system. In this deficiency, a project entitled ARICABA, strives to implement a pilot surveillance system across three islands: Martinique, St. Lucia, and Dominica. The aim of this project is to establish a network for epidemiological surveillance of infectious diseases, utilizing information and communication technology. This paper describes the system design and development strategies of a "network of networks" surveillance system for infectious diseases in the Caribbean. Also described are benefits, challenges, and limitations of this approach across the three island nations identified through direct observation, open-ended interviews, and email communications with an on-site IT consultant, key informants, and the project director. Identified core systems design of the ARICABA data warehouse include a disease monitoring system and a syndromic surveillance system. Three components comprise the development strategy: the data warehouse server, the geographical information system, and forecasting algorithms; these are recognized technical priorities of the surveillance system. A main benefit of the ARICABA surveillance system is improving responsiveness and representativeness of existing health systems through automated data collection, process, and transmission of information from various sources. Challenges include overcoming technology gaps between countries; real-time data collection points; multiple language support; and "component-oriented" development approaches.

Infectious Disease Surveillance in the Big Data Era: Towards Faster and Locally Relevant Systems.

PubMed

Simonsen, Lone; Gog, Julia R; Olson, Don; Viboud, Cécile

2016-12-01

While big data have proven immensely useful in fields such as marketing and earth sciences, public health is still relying on more traditional surveillance systems and awaiting the fruits of a big data revolution. A new generation of big data surveillance systems is needed to achieve rapid, flexible, and local tracking of infectious diseases, especially for emerging pathogens. In this opinion piece, we reflect on the long and distinguished history of disease surveillance and discuss recent developments related to use of big data. We start with a brief review of traditional systems relying on clinical and laboratory reports. We then examine how large-volume medical claims data can, with great spatiotemporal resolution, help elucidate local disease patterns. Finally, we review efforts to develop surveillance systems based on digital and social data streams, including the recent rise and fall of Google Flu Trends. We conclude by advocating for increased use of hybrid systems combining information from traditional surveillance and big data sources, which seems the most promising option moving forward. Throughout the article, we use influenza as an exemplar of an emerging and reemerging infection which has traditionally been considered a model system for surveillance and modeling. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Development of the Diabetes Technology Society Blood Glucose Monitor System Surveillance Protocol

PubMed Central

Klonoff, David C.; Lias, Courtney; Beck, Stayce; Parkes, Joan Lee; Kovatchev, Boris; Vigersky, Robert A.; Arreaza-Rubin, Guillermo; Burk, Robert D.; Kowalski, Aaron; Little, Randie; Nichols, James; Petersen, Matt; Rawlings, Kelly; Sacks, David B.; Sampson, Eric; Scott, Steve; Seley, Jane Jeffrie; Slingerland, Robbert; Vesper, Hubert W.

2015-01-01

Background: Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs. Methods: The DTS BGMS Surveillance Program Steering Committee included experts in glucose monitoring, surveillance testing, and regulatory science. Over one year, the committee engaged in meetings and teleconferences aiming to describe how to conduct BGMS surveillance studies in a scientifically sound manner that is in compliance with good clinical practice and all relevant regulations. Results: A clinical surveillance protocol was created that contains performance targets and analytical accuracy-testing studies with marketed BGMS products conducted by qualified clinical and laboratory sites. This protocol entitled “Protocol for the Diabetes Technology Society Blood Glucose Monitor System Surveillance Program” is attached as supplementary material. Conclusion: This program is needed because currently once a BGMS product has been cleared for use by the FDA, no systematic postmarket Surveillance Program exists that can monitor analytical performance and detect potential problems. This protocol will allow identification of inaccurate and unreliable BGMSs currently available on the US market. The DTS Surveillance Program will provide BGMS manufacturers a benchmark to understand the postmarket analytical performance of their products. Furthermore, patients, health care professionals, payers, and regulatory agencies will be able to use the results of the study to make informed decisions to, respectively, select, prescribe, finance, and regulate BGMSs on the market. PMID:26481642

Development of the Diabetes Technology Society Blood Glucose Monitor System Surveillance Protocol.

PubMed

Klonoff, David C; Lias, Courtney; Beck, Stayce; Parkes, Joan Lee; Kovatchev, Boris; Vigersky, Robert A; Arreaza-Rubin, Guillermo; Burk, Robert D; Kowalski, Aaron; Little, Randie; Nichols, James; Petersen, Matt; Rawlings, Kelly; Sacks, David B; Sampson, Eric; Scott, Steve; Seley, Jane Jeffrie; Slingerland, Robbert; Vesper, Hubert W

2016-05-01

Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs. The DTS BGMS Surveillance Program Steering Committee included experts in glucose monitoring, surveillance testing, and regulatory science. Over one year, the committee engaged in meetings and teleconferences aiming to describe how to conduct BGMS surveillance studies in a scientifically sound manner that is in compliance with good clinical practice and all relevant regulations. A clinical surveillance protocol was created that contains performance targets and analytical accuracy-testing studies with marketed BGMS products conducted by qualified clinical and laboratory sites. This protocol entitled "Protocol for the Diabetes Technology Society Blood Glucose Monitor System Surveillance Program" is attached as supplementary material. This program is needed because currently once a BGMS product has been cleared for use by the FDA, no systematic postmarket Surveillance Program exists that can monitor analytical performance and detect potential problems. This protocol will allow identification of inaccurate and unreliable BGMSs currently available on the US market. The DTS Surveillance Program will provide BGMS manufacturers a benchmark to understand the postmarket analytical performance of their products. Furthermore, patients, health care professionals, payers, and regulatory agencies will be able to use the results of the study to make informed decisions to, respectively, select, prescribe, finance, and regulate BGMSs on the market. © 2015 Diabetes Technology Society.

High Levels of Transmitted HIV Drug Resistance in a Study in Papua New Guinea.

PubMed

Lavu, Evelyn; Kave, Ellan; Mosoro, Euodia; Markby, Jessica; Aleksic, Eman; Gare, Janet; Elsum, Imogen A; Nano, Gideon; Kaima, Petronia; Dala, Nick; Gurung, Anup; Bertagnolio, Silvia; Crowe, Suzanne M; Myatt, Mark; Hearps, Anna C; Jordan, Michael R

2017-01-01

Papua New Guinea is a Pacific Island nation of 7.3 million people with an estimated HIV prevalence of 0.8%. ART initiation and monitoring are guided by clinical staging and CD4 cell counts, when available. Little is known about levels of transmitted HIV drug resistance in recently infected individuals in Papua New Guinea. Surveillance of transmitted HIV drug resistance in a total of 123 individuals recently infected with HIV and aged less than 30 years was implemented in Port Moresby (n = 62) and Mount Hagen (n = 61) during the period May 2013-April 2014. HIV drug resistance testing was performed using dried blood spots. Transmitted HIV drug resistance was defined by the presence of one or more drug resistance mutations as defined by the World Health Organization surveillance drug resistance mutations list. The prevalence of non-nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 16.1% (95% CI 8.8%-27.4%) and 8.2% (95% CI 3.2%-18.2%) in Port Moresby and Mount Hagen, respectively. The prevalence of nucleoside reverse transcriptase inhibitor transmitted HIV drug resistance was 3.2% (95% CI 0.2%-11.7%) and 3.3% (95% CI 0.2%-11.8%) in Port Moresby and Mount Hagen, respectively. No protease inhibitor transmitted HIV drug resistance was observed. The level of non-nucleoside reverse transcriptase inhibitor drug resistance in antiretroviral drug naïve individuals recently infected with HIV in Port Moresby is amongst the highest reported globally. This alarming level of transmitted HIV drug resistance in a young sexually active population threatens to limit the on-going effective use of NNRTIs as a component of first-line ART in Papua New Guinea. To support the choice of nationally recommended first-line antiretroviral therapy, representative surveillance of HIV drug resistance among antiretroviral therapy initiators in Papua New Guinea should be urgently implemented.

NASA Low Visibility Landing and Surface Operations (LVLASO) Atlanta Demonstration: Surveillance Systems Performance Analysis

NASA Technical Reports Server (NTRS)

Cassell, Rick; Evers, Carl; Hicok, Dan; Lee, Derrick

1999-01-01

NASA conducted a series of flight experiments at Hartsfield Atlanta International Airport as part of the Low Visibility Landing and Surface Operations (LVLASO) Program. LVLASO is one of the subelements of the NASA Terminal Area Productivity (TAP) Program, which is focused on providing technology and operating procedures for achieving clear-weather airport capacity in instrument-weather conditions, while also improving safety. LVLASO is investigating various technologies to be applied to airport surface operations, including advanced flight deck displays and surveillance systems. The purpose of this report is to document the performance of the surveillance systems tested as part of the LVLASO flight experiment. There were three surveillance sensors tested: primary radar using Airport Surface Detection Equipment (ASDE-3) and the Airport Movement Area Safety System (AMASS), Multilateration using the Airport Surface Target Identification System (ATIDS), and Automatic Dependent Surveillance - Broadcast (ADS-B) operating at 1090 MHz. The performance was compared to the draft requirements of the ICAO Advanced Surface Movement Guidance and Control System (A-SMGCS). Performance parameters evaluated included coverage, position accuracy, and update rate. Each of the sensors was evaluated as a stand alone surveillance system.

Survey of Communicable Diseases Surveillance System in Hospitals of Iran: A Qualitative Approach

PubMed Central

Dehcheshmeh, Nayeb Fadaei; Arab, Mohammad; Foroushani, Abbas Rahimi; Farzianpour, Fereshteh

2016-01-01

Background: Communicable Disease Surveillance and reporting is one of the key elements to combat against diseases and their control. Fast and timely recognition of communicable diseases can be helpful in controlling of epidemics. One of the main sources of management of communicable diseases reporting is hospitals that collect communicable diseases’ reports and send them to health authorities. One of the focal problems and challenges in this regard is incomplete and imprecise reports from hospitals. In this study, while examining the implementation processes of the communicable diseases surveillance in hospitals, non-medical people who were related to the program have been studied by a qualitative approach. Methods: This study was conducted using qualitative content analysis method. Participants in the study included 36 informants, managers, experts associated with health and surveillance of communicable diseases that were selected using targeted sampling and with diverse backgrounds and work experience (different experiences in primary health surveillance and treatment, Ministry levels, university staff and operations (hospitals and health centers) and sampling was continued until arrive to data saturation. Results: Interviews were analyzed after the elimination of duplicate codes and integration of them. Finally, 73 codes were acquired and categorized in 6 major themes and 21 levels. The main themes included: policy making and planning, development of resources, organizing, collaboration and participation, surveillance process, and monitoring and evaluation of the surveillance system. In point of interviewees, attention to these themes is necessary to develop effective and efficient surveillance system for communicable diseases. Conclusion: Surveillance system in hospitals is important in developing proper macro - policies in health sector, adoption of health related decisions and preventive plans appropriate to the existing situation. Compilation, changing

MATSurv: multisensor air traffic surveillance system

NASA Astrophysics Data System (ADS)

Yeddanapudi, Murali; Bar-Shalom, Yaakov; Pattipati, Krishna R.; Gassner, Richard R.

1995-09-01

This paper deals with the design and implementation of MATSurv 1--an experimental Multisensor Air Traffic Surveillance system. The proposed system consists of a Kalman filter based state estimator used in conjunction with a 2D sliding window assignment algorithm. Real data from two FAA radars is used to evaluate the performance of this algorithm. The results indicate that the proposed algorithm provides a superior classification of the measurements into tracks (i.e., the most likely aircraft trajectories) when compared to the aircraft trajectories obtained using the measurement IDs (squawk or IFF code).

Twitter web-service for soft agent reporting in persistent surveillance systems

NASA Astrophysics Data System (ADS)

Rababaah, Haroun; Shirkhodaie, Amir

2010-04-01

Persistent surveillance is an intricate process requiring monitoring, gathering, processing, tracking, and characterization of many spatiotemporal events occurring concurrently. Data associated with events can be readily attained by networking of hard (physical) sensors. Sensors may have homogeneous or heterogeneous (hybrid) sensing modalities with different communication bandwidth requirements. Complimentary to hard sensors are human observers or "soft sensors" that can report occurrences of evolving events via different communication devices (e.g., texting, cell phones, emails, instant messaging, etc.) to the command control center. However, networking of human observers in ad-hoc way is rather a difficult task. In this paper, we present a Twitter web-service for soft agent reporting in persistent surveillance systems (called Web-STARS). The objective of this web-service is to aggregate multi-source human observations in hybrid sensor networks rapidly. With availability of Twitter social network, such a human networking concept can not only be realized for large scale persistent surveillance systems (PSS), but also, it can be employed with proper interfaces to expedite rapid events reporting by human observers. The proposed technique is particularly suitable for large-scale persistent surveillance systems with distributed soft and hard sensor networks. The efficiency and effectiveness of the proposed technique is measured experimentally by conducting several simulated persistent surveillance scenarios. It is demonstrated that by fusion of information from hard and soft agents improves understanding of common operating picture and enhances situational awareness.

Evaluation of the influenza sentinel surveillance system in Madagascar, 2009–2014

PubMed Central

Rakotoarisoa, Alain; Randrianasolo, Laurence; Tempia, Stefano; Guillebaud, Julia; Razanajatovo, Norosoa; Randriamampionona, Lea; Piola, Patrice; Halm, Ariane

2017-01-01

Abstract Problem Evaluation of influenza surveillance systems is poor, especially in Africa. Approach In 2007, the Institut Pasteur de Madagascar and the Malagasy Ministry of Public Health implemented a countrywide system for the prospective syndromic and virological surveillance of influenza-like illnesses. In assessing this system’s performance, we identified gaps and ways to promote the best use of resources. We investigated acceptability, data quality, flexibility, representativeness, simplicity, stability, timeliness and usefulness and developed qualitative and/or quantitative indicators for each of these attributes. Local setting Until 2007, the influenza surveillance system in Madagascar was only operational in Antananarivo and the observations made could not be extrapolated to the entire country. Relevant changes By 2014, the system covered 34 sentinel sites across the country. At 12 sites, nasopharyngeal and/or oropharyngeal samples were collected and tested for influenza virus. Between 2009 and 2014, 177 718 fever cases were detected, 25 809 (14.5%) of these fever cases were classified as cases of influenza-like illness. Of the 9192 samples from patients with influenza-like illness that were tested for influenza viruses, 3573 (38.9%) tested positive. Data quality for all evaluated indicators was categorized as above 90% and the system also appeared to be strong in terms of its acceptability, simplicity and stability. However, sample collection needed improvement. Lessons learnt The influenza surveillance system in Madagascar performed well and provided reliable and timely data for public health interventions. Given its flexibility and overall moderate cost, this system may become a useful platform for syndromic and laboratory-based surveillance in other low-resource settings. PMID:28479639

Evaluation of dried blood spot protocols with the Bio-Rad GS HIV Combo Ag/Ab EIA and Geenius™ HIV 1/2 Supplemental Assay.

PubMed

Luo, Wei; Davis, Geoff; Li, LiXia; Shriver, M Kathleen; Mei, Joanne; Styer, Linda M; Parker, Monica M; Smith, Amanda; Paz-Bailey, Gabriela; Ethridge, Steve; Wesolowski, Laura; Owen, S Michele; Masciotra, Silvina

2017-06-01

FDA-approved antigen/antibody combo and HIV-1/2 differentiation supplemental tests do not have claims for dried blood spot (DBS) use. We compared two DBS-modified protocols, the Bio-Rad GS HIV Combo Ag/Ab (BRC) EIA and Geenius™ HIV-1/2 (Geenius) Supplemental Assay, to plasma protocols and evaluated them in the CDC/APHL HIV diagnostic algorithm. BRC-DBS p24 analytical sensitivity was calculated from serial dilutions of p24. DBS specimens included 11 HIV-1 seroconverters, 151 HIV-1-positive individuals, including 20 on antiretroviral therapy, 31 HIV-2-positive and one HIV-1/HIV-2-positive individuals. BRC-reactive specimens were tested with Geenius using the same DBS eluate. Matched plasma specimens were tested with BRC, an IgG/IgM immunoassay and Geenius. DBS and plasma results were compared using the McNemar's test. A DBS-algorithm applied to 348 DBS from high-risk individuals who participated in surveillance was compared to HIV status based on local testing algorithms. BRC-DBS detects p24 at a concentration 18 times higher than in plasma. In seroconverters, BRC-DBS detected more infections than the IgG/IgM immunoassay in plasma (p=0.0133), but fewer infections than BRC-plasma (p=0.0133). In addition, the BRC/Geenius-plasma algorithm identified more HIV-1 infections than the BRC/Geenius-DBS algorithm (p=0.0455). The DBS protocols correctly identified HIV status for established HIV-1 infections, including those on therapy, HIV-2 infections, and surveillance specimens. The DBS protocols exhibited promising performance and allowed rapid supplemental testing. Although the DBS algorithm missed some early infections, it showed similar results when applied to specimens from a high-risk population. Implementation of a DBS algorithm would benefit testing programs without capacity for venipuncture. Published by Elsevier B.V.

A Radiation-Triggered Surveillance System for UF6 Cylinder Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Curtis, Michael M.; Myjak, Mitchell J.

This report provides background information and representative scenarios for testing a prototype radiation-triggered surveillance system at an operating facility that handles uranium hexafluoride (UF 6) cylinders. The safeguards objective is to trigger cameras using radiation, or radiation and motion, rather than motion alone, to reduce significantly the number of image files generated by a motion-triggered system. The authors recommend the use of radiation-triggered surveillance at all facilities where cylinder paths are heavily traversed by personnel. The International Atomic Energy Agency (IAEA) has begun using surveillance cameras in the feed and withdrawal areas of gas centrifuge enrichment plants (GCEPs). The camerasmore » generate imagery using elapsed time or motion, but this creates problems in areas occupied 24/7 by personnel. Either motion-or-interval-based triggering generates thousands of review files over the course of a month. Since inspectors must review the files to verify operator material-flow-declarations, a plethora of files significantly extends the review process. The primary advantage of radiation-triggered surveillance is the opportunity to obtain full-time cylinder throughput verification versus what presently amounts to part-time verification. Cost savings should be substantial, as the IAEA presently uses frequent unannounced inspections to verify cylinder-throughput declarations. The use of radiation-triggered surveillance allows the IAEA to implement less frequent unannounced inspections for the purpose of flow verification, but its principal advantage is significantly shorter and more effective inspector video reviews.« less

Automated intelligent video surveillance system for ships

NASA Astrophysics Data System (ADS)

Wei, Hai; Nguyen, Hieu; Ramu, Prakash; Raju, Chaitanya; Liu, Xiaoqing; Yadegar, Jacob

2009-05-01

To protect naval and commercial ships from attack by terrorists and pirates, it is important to have automatic surveillance systems able to detect, identify, track and alert the crew on small watercrafts that might pursue malicious intentions, while ruling out non-threat entities. Radar systems have limitations on the minimum detectable range and lack high-level classification power. In this paper, we present an innovative Automated Intelligent Video Surveillance System for Ships (AIVS3) as a vision-based solution for ship security. Capitalizing on advanced computer vision algorithms and practical machine learning methodologies, the developed AIVS3 is not only capable of efficiently and robustly detecting, classifying, and tracking various maritime targets, but also able to fuse heterogeneous target information to interpret scene activities, associate targets with levels of threat, and issue the corresponding alerts/recommendations to the man-in- the-loop (MITL). AIVS3 has been tested in various maritime scenarios and shown accurate and effective threat detection performance. By reducing the reliance on human eyes to monitor cluttered scenes, AIVS3 will save the manpower while increasing the accuracy in detection and identification of asymmetric attacks for ship protection.

Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.

PubMed

Buehler, James W; Hopkins, Richard S; Overhage, J Marc; Sosin, Daniel M; Tong, Van

2004-05-07

The threat of terrorism and high-profile disease outbreaks has drawn attention to public health surveillance systems for early detection of outbreaks. State and local health departments are enhancing existing surveillance systems and developing new systems to better detect outbreaks through public health surveillance. However, information is limited about the usefulness of surveillance systems for outbreak detection or the best ways to support this function. This report supplements previous guidelines for evaluating public health surveillance systems. Use of this framework is intended to improve decision-making regarding the implementation of surveillance for outbreak detection. Use of a standardized evaluation methodology, including description of system design and operation, also will enhance the exchange of information regarding methods to improve early detection of outbreaks. The framework directs particular attention to the measurement of timeliness and validity for outbreak detection. The evaluation framework is designed to support assessment and description of all surveillance approaches to early detection, whether through traditional disease reporting, specialized analytic routines for aberration detection, or surveillance using early indicators of disease outbreaks, such as syndromic surveillance.

Timing of entry to care by newly diagnosed HIV cases before and after the 2010 New York State HIV testing law.

PubMed

Gordon, Daniel E; Bian, Fuqin; Anderson, Bridget J; Smith, Lou C

2015-01-01

Prompt entry to care after HIV diagnosis benefits the infected individual and reduces the likelihood of further transmission of the virus. The New York State HIV Testing Law of 2010 requires diagnosing providers to refer persons newly diagnosed with HIV to follow-up medical care. This study used routinely collected HIV-related laboratory data from the New York State HIV surveillance system to assess whether the fraction of newly diagnosed cases entering care within 90 days of diagnosis increased after the implementation of the law. Laboratory data on 23,302 newly diagnosed cases showed that entry to care within 90 days rose steadily from 72.0% in 2007 to 85.4% in 2012. The rise was observed across all race/ethnic groups, ages, transmission risk groups, sexes, and regions of residence. Logistic regression analyses of entry to care pre-law and post-law, controlling for demographic characteristics, transmission risk, and geographic area, indicate that percentage of newly diagnosed cases entering care within 90 days grew more rapidly in the post-law period. This is consistent with a positive effect of the law on entry to care.

Quantitative and qualitative assessment of the bovine abortion surveillance system in France.

PubMed

Bronner, Anne; Gay, Emilie; Fortané, Nicolas; Palussière, Mathilde; Hendrikx, Pascal; Hénaux, Viviane; Calavas, Didier

2015-06-01

Bovine abortion is the main clinical sign of bovine brucellosis, a disease of which France has been declared officially free since 2005. To ensure the early detection of any brucellosis outbreak, event-driven surveillance relies on the mandatory notification of bovine abortions and the brucellosis testing of aborting cows. However, the under-reporting of abortions appears frequent. Our objectives were to assess the aptitude of the bovine abortion surveillance system to detect each and every bovine abortion and to identify factors influencing the system's effectiveness. We evaluated five attributes defined by the U.S. Centers for Disease Control with a method suited to each attribute: (1) data quality was studied quantitatively and qualitatively, as this factor considerably influences data analysis and results; (2) sensitivity and representativeness were estimated using a unilist capture-recapture approach to quantify the surveillance system's effectiveness; (3) acceptability and simplicity were studied through qualitative interviews of actors in the field, given that the surveillance system relies heavily on abortion notifications by farmers and veterinarians. Our analysis showed that (1) data quality was generally satisfactory even though some errors might be due to actors' lack of awareness of the need to collect accurate data; (2) from 2006 to 2011, the mean annual sensitivity - i.e. the proportion of farmers who reported at least one abortion out of all those who detected such events - was around 34%, but was significantly higher in dairy than beef cattle herds (highlighting a lack of representativeness); (3) overall, the system's low sensitivity was related to its low acceptability and lack of simplicity. This study showed that, in contrast to policy-makers, most farmers and veterinarians perceived the risk of a brucellosis outbreak as negligible. They did not consider sporadic abortions as a suspected case of brucellosis and usually reported abortions only to

Antiretroviral drug susceptibility among drug-naive adults with recent HIV infection in Rakai, Uganda

PubMed Central

Eshleman, Susan H.; Laeyendecker, Oliver; Parkin, Neil; Huang, Wei; Chappey, Colombe; Paquet, Agnes C.; Serwadda, David; Reynolds, Steven J.; Kiwanuka, Noah; Quinn, Thomas C.; Gray, Ronald; Wawer, Maria

2009-01-01

Objective To analyze antiretroviral drug susceptibility in HIV from recently infected adults in Rakai, Uganda, prior to the availability of antiretroviral drug treatment. Methods Samples obtained at the time of HIV seroconversion (1998–2003) were analyzed using the GeneSeq HIV and PhenoSense HIV assays (Monogram Biosciences, Inc., South San Francisco, California, USA). Results Test results were obtained for 104 samples (subtypes: 26A, 1C, 66D, 9A/D, 1C/D, 1 intersubtype recombinant). Mutations used for genotypic surveillance of transmitted antiretroviral drug resistance were identified in six samples: three had nucleoside reverse transcriptase inhibitor (NRTI) surveillance mutations (two had M41L, one had K219R), and three had protease inhibitor surveillance mutations (I47V, F53L, N88D); none had nonnucleoside reverse transcriptase inhibitor (NNRTI) surveillance mutations. Other resistance-associated mutations were identified in some samples. However, none of the samples had a sufficient number of mutations to predict reduced antiretroviral drug susceptibility. Ten (9.6%) of the samples had reduced phenotypic susceptibility to at least one drug (one had partial susceptibility to didanosine, one had nevirapine resistance, and eight had resistance or partial susceptibility to at least one protease inhibitor). Fifty-three (51%) of the samples had hypersusceptibility to at least one drug (seven had zidovudine hypersusceptibility, 28 had NNRTI hypersusceptibility, 34 had protease inhibitor hypersusceptibility). Delavirdine hyper-susceptibility was more frequent in subtype A than D. In subtype D, efavirenz hypersusceptibility was associated with substitutions at codon 11 in HIV-reverse transcriptase. Conclusion Phenotyping detected reduced antiretroviral drug susceptibility and hypersusceptibility in HIV from some antiretroviral-naive Ugandan adults that was not predicted by genotyping. Phenotyping may complement genotyping for analysis of antiretroviral drug

Antiretroviral drug susceptibility among drug-naive adults with recent HIV infection in Rakai, Uganda.

PubMed

Eshleman, Susan H; Laeyendecker, Oliver; Parkin, Neil; Huang, Wei; Chappey, Colombe; Paquet, Agnes C; Serwadda, David; Reynolds, Steven J; Kiwanuka, Noah; Quinn, Thomas C; Gray, Ronald; Wawer, Maria

2009-04-27

To analyze antiretroviral drug susceptibility in HIV from recently infected adults in Rakai, Uganda, prior to the availability of antiretroviral drug treatment. Samples obtained at the time of HIV seroconversion (1998-2003) were analyzed using the GeneSeq HIV and PhenoSense HIV assays (Monogram Biosciences, Inc., South San Francisco, California, USA). Test results were obtained for 104 samples (subtypes: 26A, 1C, 66D, 9A/D, 1C/D, 1 intersubtype recombinant). Mutations used for genotypic surveillance of transmitted antiretroviral drug resistance were identified in six samples: three had nucleoside reverse transcriptase inhibitor (NRTI) surveillance mutations (two had M41L, one had K219R), and three had protease inhibitor surveillance mutations (I47V, F53L, N88D); none had nonnucleoside reverse transcriptase inhibitor (NNRTI) surveillance mutations. Other resistance-associated mutations were identified in some samples. However, none of the samples had a sufficient number of mutations to predict reduced antiretroviral drug susceptibility. Ten (9.6%) of the samples had reduced phenotypic susceptibility to at least one drug (one had partial susceptibility to didanosine, one had nevirapine resistance, and eight had resistance or partial susceptibility to at least one protease inhibitor). Fifty-three (51%) of the samples had hypersusceptibility to at least one drug (seven had zidovudine hypersusceptibility, 28 had NNRTI hypersusceptibility, 34 had protease inhibitor hypersusceptibility). Delavirdine hypersusceptibility was more frequent in subtype A than D. In subtype D, efavirenz hypersusceptibility was associated with substitutions at codon 11 in HIV-reverse transcriptase. Phenotyping detected reduced antiretroviral drug susceptibility and hypersusceptibility in HIV from some antiretroviral-naive Ugandan adults that was not predicted by genotyping. Phenotyping may complement genotyping for analysis of antiretroviral drug susceptibility in populations with nonsubtype B

NASA's Systems Engineering Approaches for Addressing Public Health Surveillance Requirements

NASA Technical Reports Server (NTRS)

Vann, Timi

2003-01-01

NASA's systems engineering has its heritage in space mission analysis and design, including the end-to-end approach to managing every facet of the extreme engineering required for successful space missions. NASA sensor technology, understanding of remote sensing, and knowledge of Earth system science, can be powerful new tools for improved disease surveillance and environmental public health tracking. NASA's systems engineering framework facilitates the match between facilitates the match between partner needs and decision support requirements in the areas of 1) Science/Data; 2) Technology; 3) Integration. Partnerships between NASA and other Federal agencies are diagrammed in this viewgraph presentation. NASA's role in these partnerships is to provide systemic and sustainable solutions that contribute to the measurable enhancement of a partner agency's disease surveillance efforts.

[National Antimicrobial Resistance Surveillance System (NAMRSS) external quality assessment studies: 2011-2016].

PubMed

Süzük Yıldız, Serap; Şimşek, Hüsniye; Çöplü, Nilay; Gülay, Zeynep

2017-07-01

Establishment of sustainable and evidence-based surveillance systems are recommended for prevention of microbial resistance by the World Health Organization (WHO). As a necessity of these surveillance systems, participants are recommended to implement an external quality assessment (EQA) program. In this scope, National Antimicrobial Resistance Surveillance System (NARSS) has been established within the Public Health Institute of Turkey (PHIT) in our country since 2011. In the scope of this surveillance, NARSS EQA program has been implemented in a cycle per year and four isolates were sent to participants per cycle every year since 2011. In this study, it was aimed to evaluate the six years results of the EQA programs being implemented on NARSS participants between 2011 and 2016. The surveillance system consisted of 118 laboratories. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium/faecalis and Acinetobacter baumannii bacteria included in scope of the surveillance were sent to participants. Identification of bacteria to the species level, verification of the antibiotic susceptibility test results and existence of specified resistance of the isolates performed with valid test methods required from the participants. Identified isolates were cultured with routine microbiological methods and sent to participants in ambient temperature in triple carrying pouches inside suitable carrying media via PTT Cargo. The results were entered by means of passwords prepared by PHIT and sent to the web based system. The analysis of results were made with SPSS program. A total of twenty-three isolates were sent to participants between 2011 and 2016. It was determined that participants commonly preferred automated systems for bacterial identification and antibiotic sensitivity test results. The use of MALDI TOF MS system was determined to be raised up to 15.65% in 2016. It has been determined that

Social Media and Internet-Based Data in Global Systems for Public Health Surveillance: A Systematic Review

PubMed Central

VELASCO, EDWARD; AGHENEZA, TUMACHA; DENECKE, KERSTIN; KIRCHNER, GÖRAN; ECKMANNS, TIM

2014-01-01

Context: The exchange of health information on the Internet has been heralded as an opportunity to improve public health surveillance. In a field that has traditionally relied on an established system of mandatory and voluntary reporting of known infectious diseases by doctors and laboratories to governmental agencies, innovations in social media and so-called user-generated information could lead to faster recognition of cases of infectious disease. More direct access to such data could enable surveillance epidemiologists to detect potential public health threats such as rare, new diseases or early-level warnings for epidemics. But how useful are data from social media and the Internet, and what is the potential to enhance surveillance? The challenges of using these emerging surveillance systems for infectious disease epidemiology, including the specific resources needed, technical requirements, and acceptability to public health practitioners and policymakers, have wide-reaching implications for public health surveillance in the 21st century. Methods: This article divides public health surveillance into indicator-based surveillance and event-based surveillance and provides an overview of each. We did an exhaustive review of published articles indexed in the databases PubMed, Scopus, and Scirus between 1990 and 2011 covering contemporary event-based systems for infectious disease surveillance. Findings: Our literature review uncovered no event-based surveillance systems currently used in national surveillance programs. While much has been done to develop event-based surveillance, the existing systems have limitations. Accordingly, there is a need for further development of automated technologies that monitor health-related information on the Internet, especially to handle large amounts of data and to prevent information overload. The dissemination to health authorities of new information about health events is not always efficient and could be improved. No

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees.

PubMed

Rivière, Julie; Le Strat, Yann; Hendrikx, Pascal; Dufour, Barbara

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees

PubMed Central

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in

A global survey of adverse event following immunization surveillance systems for pregnant women and their infants.

PubMed

Cassidy, Christine; MacDonald, Noni E; Steenbeek, Audrey; Ortiz, Justin R; Zuber, Patrick L F; Top, Karina A

2016-08-02

Strengthening antenatal care as a platform for maternal immunization is a priority of the World Health Organization (WHO). Systematic surveillance for adverse events following immunization (AEFI) in pregnancy is needed to identify vaccine safety events. We sought to identify active and passive AEFI surveillance systems for pregnant women and infants. Representatives from all National Pharmacovigilance Centers and a convenience sample of vaccine safety experts were invited to complete a 14-item online survey in English, French or Spanish. The survey captured maternal immunization policies, and active and passive AEFI surveillance systems for pregnant women and infants in respondents' countries. The analysis was descriptive. We received responses from 51/185 (28%) invited persons from 47/148 (32%) countries representing all WHO regions, and low, middle and high-income countries. Thirty countries had national immunization policies targeting pregnant women. Eleven countries had active surveillance systems to detect serious AEFI in pregnant women and/or their infants, including six low and middle-income countries (LMIC). Thirty-nine countries had passive surveillance systems, including 23 LMIC. These active and passive surveillance programs cover approximately 8% and 56% of the worldwide annual birth cohort, respectively. Data from one active and four passive systems have been published. We identified 50 active and passive AEFI surveillance systems for pregnant women and infants, but few have published their findings. AEFI surveillance appears to be feasible in low and high resource settings. Further expansion of AEFI surveillance for pregnant women and sharing of vaccine safety information will provide additional evidence in support of maternal immunization policies.

Antimicrobial sensitivity pattern of Salmonella: comparison of isolates from HIV-infected and HIV-uninfected patients.

PubMed

Wolday, D; Erge, W

1998-07-01

A retrospective analysis of all cases of Salmonella infections occurring between 1991 and 1995 was undertaken in order to evaluate the antimicrobial sensitivity pattern of the isolates from both human immunodeficiency virus (HIV) infected and uninfected Ethiopian patients. During the 5-year study period, we identified 147 cases of Salmonella infections. Only in 49 cases was the HIV serostatus known; 22 (44.9%) of the infections were in HIV seronegative patients while 27 (55.9%) were in HIV seropositive patients. The strains were isolated from blood (71.4%), urine (18.4%) and stool (8.2%). Salmonella infection was found to be more frequent (55.15% versus 44.9%) among HIV positive than HIV-negative patients. Moreover, Salmonella isolates recovered from HIV-seropositive patients were significantly resistant to many of the antibiotics tested when compared to the isolates from HIV-seronegative patients. The only chloramphenicol resistant Salmonella typhi occurred in a patient who was seropositive for HIV. According to these results, Ethiopian patients infected with HIV may be at risk of acquiring infections, especially non-typhoidal salmonellas, that are multi-drug resistant (MDR) strains than HIV-uninfected subjects. The emergence of MDR Salmonella infection among HIV-positive patients requires reassessment of chemotherapeutic approaches in this patient population, and warrants continued laboratory surveillance.

Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS).

PubMed

Beguy, Donatien; Elung'ata, Patricia; Mberu, Blessing; Oduor, Clement; Wamukoya, Marylene; Nganyi, Bonface; Ezeh, Alex

2015-04-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first urban-based longitudinal health and demographic surveillance platform in sub-Saharan Africa (SSA). The NUHDSS was established in 2002 to provide a platform to investigate the long-term social, economic and health consequences of urban residence, and to serve as a primary research tool for intervention and impact evaluation studies focusing on the needs of the urban poor in SSA. Since its inception, the NUHDSS has successfully followed every year a population of about 65,000 individuals in 24,000 households in two slum communities--Korogocho and Viwandani--in Nairobi, Kenya. Data collected include key demographic and health information (births, deaths including verbal autopsy, in- and out-migration, immunization) and other information that characterizes living conditions in the slums (livelihood opportunities, household amenities and possessions, type of housing etc.). In addition to the routine data, it has provided a robust platform for nesting several studies examining the challenges of rapid urbanization in SSA and associated health and poverty dynamics. NUHDSS data are shared through internal and external collaborations, in accordance with the Centre's guidelines for publications, data sharing. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

A comparison of four sampling methods among men having sex with men in China: implications for HIV/STD surveillance and prevention.

PubMed

Guo, Yan; Li, Xiaoming; Fang, Xiaoyi; Lin, Xiuyun; Song, Yan; Jiang, Shuling; Stanton, Bonita

2011-11-01

Sample representativeness remains one of the challenges in effective HIV/STD surveillance and prevention targeting men who have sex with men (MSM) worldwide. Although convenience samples are widely used in studies of MSM, previous studies suggested that these samples might not be representative of the broader MSM population. This issue becomes even more critical in many developing countries where needed resources for conducting probability sampling are limited. We examined variations in HIV and Syphilis infections and sociodemographic and behavioral factors among 307 young migrant MSM recruited using four different convenience sampling methods (peer outreach, informal social network, Internet, and venue-based) in Beijing, China in 2009. The participants completed a self-administered survey and provided blood specimens for HIV/STD testing. Among the four MSM samples using different recruitment methods, rates of HIV infections were 5.1%, 5.8%, 7.8%, and 3.4%; rates of Syphilis infection were 21.8%, 36.2%, 11.8%, and 13.8%; and rates of inconsistent condom use were 57%, 52%, 58%, and 38%. Significant differences were found in various sociodemographic characteristics (e.g., age, migration history, education, income, and places of employment) and risk behaviors (e.g., age at first sex, number of sex partners, involvement in commercial sex, and substance use) among samples recruited by different sampling methods. The results confirmed the challenges of obtaining representative MSM samples and underscored the importance of using multiple sampling methods to reach MSM from diverse backgrounds and in different social segments and to improve the representativeness of the MSM samples when the use of probability sampling approach is not feasible.

A survey of core and support activities of communicable disease surveillance systems at operating-level CDCs in China.

PubMed

Xiong, Weiyi; Lv, Jun; Li, Liming

2010-11-17

In recent years, problems like insufficient coordination, low efficiency, and heavy working load in national communicable disease surveillance systems in China have been pointed out by many researchers. To strengthen the national communicable disease surveillance systems becomes an immediate concern. Since the World Health Organization has recommended that a structured approach to strengthen national communicable disease surveillance must include an evaluation to existing systems which usually begins with a systematic description, we conducted the first survey for communicable disease surveillance systems in China, in order to understand the situation of core and support surveillance activities at province-level and county-level centers for disease control and prevention (CDCs). A nationwide survey was conducted by mail between May and October 2006 to investigate the implementation of core and support activities of the Notifiable Disease Reporting System (NDRS) and disease-specific surveillance systems in all of the 31 province-level and selected 14 county-level CDCs in Mainland China The comments on the performance of communicable disease surveillance systems were also collected from the directors of CDCs in this survey. The core activities of NDRS such as confirmation, reporting and analysis and some support activities such as supervision and staff training were found sufficient in both province-level and county-level surveyed CDCs, but other support activities including information feedback, equipment and financial support need to be strengthened in most of the investigated CDCs. A total of 47 communicable diseases or syndromes were under surveillance at province level, and 20 diseases or syndromes at county level. The activities among different disease-specific surveillance systems varied widely. Acute flaccid paralysis (AFP), measles and tuberculosis (TB) surveillance systems got relatively high recognition both at province level and county level. China has

HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review.

PubMed

Tang, Songyuan; Tang, Weiming; Meyers, Kathrine; Chan, Polin; Chen, Zhongdan; Tucker, Joseph D

2016-10-20

Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China. We searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines. Overall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities. Improving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.

Test uptake and case detection of syphilis, HIV, and hepatitis C among women undergoing prenatal screening in British Columbia, 2007 to 2011.

PubMed

Kuo, Margot; Money, Deborah M; Alvarez, Maria; Buxton, Jane A; Krajden, Mel; Lester, Richard T; Ogilvie, Gina; Gilbert, Mark

2014-06-01

Test uptake and case detection trends for rubella, syphilis, HIV, and hepatitis C (HCV) were compared among the 2007 to 2011 cohort of women undergoing prenatal testing in British Columbia. Analysis involved linkage of provincially centralized laboratory and surveillance data to assess prenatal test uptake and rates of newly diagnosed versus prevalent infections. We included prenatal specimens submitted from BC women aged 16 to 45 years in 2007 to 2011. Laboratory records were linked to provincial surveillance systems to identify confirmed maternal syphilis and HIV cases. Previous positive status was determined for HIV and HCV if a prior confirmed case was identified from laboratory records. We determined rates of HIV and HCV newly identified at prenatal screening (new diagnoses per 100 000 per year). Prevalence for HIV and HCV was the sum of all new and prior diagnoses (prevalence per 100 000 per year). Of 233 203 women, 96.9% were screened for rubella, 93.3% for syphilis, 93.8% for HIV, and 21.5% for HCV. From 2007 to 2011, the overall rates of new diagnoses were 15.4, 5.1, and 82.8 cases per 100 000 per year for syphilis, HIV, and HCV, respectively. The overall prevalence was 45.9 and 551.5 cases per 100 000 per year for HIV and HCV, respectively (0.05% and 0.6%). From 2007 to 2011, new diagnoses of HCV decreased 40% from 106.0 to 62.1 cases per 100 000 per year. HCV prevalence did not change and increased with maternal age. This study links surveillance and laboratory data to provide a provincial picture of prenatal screening test uptake and case detection, with the advantage of distinguishing new from prior diagnoses. This information can help guide prenatal communicable disease screening policy.

From HIV infection to therapeutic response: a population-based longitudinal HIV cascade-of-care study in KwaZulu-Natal, South Africa.

PubMed

Haber, Noah; Tanser, Frank; Bor, Jacob; Naidu, Kevindra; Mutevedzi, Tinofa; Herbst, Kobus; Porter, Kholoud; Pillay, Deenan; Bärnighausen, Till

2017-05-01

Standard approaches to estimation of losses in the HIV cascade of care are typically cross-sectional and do not include the population stages before linkage to clinical care. We used indiviual-level longitudinal cascade data, transition by transition, including population stages, both to identify the health-system losses in the cascade and to show the differences in inference between standard methods and the longitudinal approach. We used non-parametric survival analysis to estimate a longitudinal HIV care cascade for a large population of people with HIV residing in rural KwaZulu-Natal, South Africa. We linked data from a longitudinal population health surveillance (which is maintained by the Africa Health Research Institute) with patient records from the local public-sector HIV treatment programme (contained in an electronic clinical HIV treatment and care database, ARTemis). We followed up all people who had been newly detected as having HIV between Jan 1, 2006, and Dec 31, 2011, across six cascade stages: three population stages (first positive HIV test, HIV status knowledge, and linkage to care) and three clinical stages (eligibility for antiretroviral therapy [ART], initiation of ART, and therapeutic response). We compared our estimates to cross-sectional cascades in the same population. We estimated the cumulative incidence of reaching a particular cascade stage at a specific time with Kaplan-Meier survival analysis. Our population consisted of 5205 individuals with HIV who were followed up for 24 031 person-years. We recorded 598 deaths. 4539 individuals gained knowledge of their positive HIV status, 2818 were linked to care, 2151 became eligible for ART, 1839 began ART, and 1456 had successful responses to therapy. We used Kaplan-Meier survival analysis to adjust for censorship due to the end of data collection, and found that 8 years after testing positive in the population health surveillance, 16% had died. Among living patients, 82% knew their HIV

The epidemic of HIV/AIDS in developing countries; the current scenario in Pakistan.

PubMed

Yousaf, Muhammad Z; Zia, Sadia; Babar, Masroor E; Ashfaq, Usman A

2011-08-12

HIV (Human Immunodeficiency virus) causes (acquired immunodeficiency syndrome) AIDS, in which the immune system of body totally fails to develop any defense against the foreign invaders. Infection with HIV occurs by transfer of blood, semen, and breast milk. HIV/AIDS is a global problem and it results nearly 25 million deaths worldwide. Developing countries like Pakistan have issues regarding Public Health. Currently, epidemic of HIV/AIDS is established in Pakistan and there is a threat of an expanded HIV/AIDS outbreak in the country. The major reason is that population is engaging in high-risk practices, low awareness about HIV/AIDS, and treacherous blood transfusion practices. A supplementary threat to Pakistan is India because both sharing a border and India is facing a rapidly growing HIV/AIDS epidemic. Local NGOs, National and International organizations are warning that in near future Pakistan may experiences bad situation regarding HIV/AIDS.In the present article we focused current situation of surveillance of HIV/AIDS, its virology, genotype, diagnostics, high-risk groups, reasons of vulnerability in Pakistani population, and the role of different national and international organizations in this situation.

HIV-1 and hijacking of the host immune system: the current scenario.

PubMed

Imran, Muhammad; Manzoor, Sobia; Saalim, Muhammad; Resham, Saleha; Ashraf, Javed; Javed, Aneela; Waqar, Ahmed Bilal

2016-10-01

Human immunodeficiency virus (HIV) infection is a major health burden across the world which leads to the development of acquired immune deficiency syndrome (AIDS). This review article discusses the prevalence of HIV, its major routes of transmission, natural immunity, and evasion from the host immune system. HIV is mostly prevalent in Sub-Saharan Africa and low income countries. It is mostly transmitted by sharing syringe needles, blood transfusion, and sexual routes. The host immune system is categorized into three main types; the innate, the adaptive, and the intrinsic immune system. Regarding the innate immune system against HIV, the key players are mucosal membrane, dendritic cells (DCs), complement system, interferon, and host Micro RNAs. The major components of the adaptive immune system exploited by HIV are T cells mainly CD4+ T cells and B cells. The intrinsic immune system confronted by HIV involves (apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3G) APOBEC3G, tripartite motif 5-α (TRIM5a), terherin, and (SAM-domain HD-domain containing protein) SAMHD1. HIV-1 efficiently interacts with the host immune system, exploits the host machinery, successfully replicates and transmits from one cell to another. Further research is required to explore evasion strategies of HIV to develop novel therapeutic approaches against HIV. © 2016 APMIS. Published by John Wiley & Sons Ltd.

Surveillance for travel-related disease--GeoSentinel Surveillance System, United States, 1997-2011.

PubMed

Harvey, Kira; Esposito, Douglas H; Han, Pauline; Kozarsky, Phyllis; Freedman, David O; Plier, D Adam; Sotir, Mark J

2013-07-19

In 2012, the number of international tourist arrivals worldwide was projected to reach a new high of 1 billion arrivals, a 48% increase from 674 million arrivals in 2000. International travel also is increasing among U.S. residents. In 2009, U.S. residents made approximately 61 million trips outside the country, a 5% increase from 1999. Travel-related morbidity can occur during or after travel. Worldwide, 8% of travelers from industrialized to developing countries report becoming ill enough to seek health care during or after travel. Travelers have contributed to the global spread of infectious diseases, including novel and emerging pathogens. Therefore, surveillance of travel-related morbidity is an essential component of global public health surveillance and will be of greater importance as international travel increases worldwide. September 1997-December 2011. GeoSentinel is a clinic-based global surveillance system that tracks infectious diseases and other adverse health outcomes in returned travelers, foreign visitors, and immigrants. GeoSentinel comprises 54 travel/tropical medicine clinics worldwide that electronically submit demographic, travel, and clinical diagnosis data for all patients evaluated for an illness or other health condition that is presumed to be related to international travel. Clinical information is collected by physicians with expertise or experience in travel/tropical medicine. Data collected at all sites are entered electronically into a database, which is housed at and maintained by CDC. The GeoSentinel network membership program comprises 235 additional clinics in 40 countries on six continents. Although these network members do not report surveillance data systematically, they can report unusual or concerning diagnoses in travelers and might be asked to perform enhanced surveillance in response to specific health events or concerns. During September 1997-December 2011, data were collected on 141,789 patients with confirmed or