It ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants
Early infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-expo...
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| creator | Chappell, Elizabeth Thorne, Claire Collins, Intira Jeannie Baisley, Kathy Yapa, H Manisha Gareta, Dickman Bärnighausen, Till Herbst, Kobus Judd, Ali |
| description | Early infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-exposed infants in rural South Africa, between 2010-2016.
We estimated the proportion of infants ever tested (methods 1-3) and tested by 7 weeks of age (1-4) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with ≥1 EID result in routine laboratory surveillance; (2) the number of infants with ≥1 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with ≥1 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants' Road-to-Health-booklets.
The proportion ever tested was 43%, 88% and 138% for methods 1-3, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1-4 respectively.
The four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants. |
| doi_str_mv | 10.1371/journal.pone.0257496 |
| format | Article |
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We estimated the proportion of infants ever tested (methods 1-3) and tested by 7 weeks of age (1-4) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with ≥1 EID result in routine laboratory surveillance; (2) the number of infants with ≥1 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with ≥1 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants' Road-to-Health-booklets.
The proportion ever tested was 43%, 88% and 138% for methods 1-3, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1-4 respectively.
The four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257496</identifier><identifier>PMID: 34591881</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Algorithms ; Babies ; Biology and Life Sciences ; Births ; Care and treatment ; Clinical trials ; Data sources ; Delivery of Health Care ; Demographic aspects ; Deoxyribonucleic acid ; Diagnosis ; DNA ; Early Diagnosis ; Estimates ; Exposure ; Gestational age ; Health aspects ; Health care ; Health facilities ; Health services ; HIV ; HIV (Viruses) ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; HIV Seroprevalence ; Human immunodeficiency virus ; Humans ; Infant ; Infant, Newborn ; Infants ; Infectious Disease Transmission, Vertical ; Laboratories ; Medical care ; Medical diagnosis ; Medical research ; Medicine and Health Sciences ; Methods ; People and Places ; Physiological aspects ; Population ; Prenatal care ; Prenatal Diagnosis ; Quality management ; Research and Analysis Methods ; Rural Population ; Serology ; South Africa - epidemiology ; Surveillance ; Womens health</subject><ispartof>PloS one, 2021-09, Vol.16 (9), p.e0257496-e0257496</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Chappell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Chappell et al 2021 Chappell et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c602t-2392b738b54fcfc21689793464fcec6feab81846ae196c8575d9dfadb4cfdb4d3</cites><orcidid>0000-0002-5436-9386 ; 0000-0003-1053-6434</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483382/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483382/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34591881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chappell, Elizabeth</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><creatorcontrib>Collins, Intira Jeannie</creatorcontrib><creatorcontrib>Baisley, Kathy</creatorcontrib><creatorcontrib>Yapa, H Manisha</creatorcontrib><creatorcontrib>Gareta, Dickman</creatorcontrib><creatorcontrib>Bärnighausen, Till</creatorcontrib><creatorcontrib>Herbst, Kobus</creatorcontrib><creatorcontrib>Judd, Ali</creatorcontrib><title>It ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Early infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-exposed infants in rural South Africa, between 2010-2016.
We estimated the proportion of infants ever tested (methods 1-3) and tested by 7 weeks of age (1-4) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with ≥1 EID result in routine laboratory surveillance; (2) the number of infants with ≥1 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with ≥1 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants' Road-to-Health-booklets.
The proportion ever tested was 43%, 88% and 138% for methods 1-3, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1-4 respectively.
The four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants.</description><subject>Algorithms</subject><subject>Babies</subject><subject>Biology and Life Sciences</subject><subject>Births</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Data sources</subject><subject>Delivery of Health Care</subject><subject>Demographic aspects</subject><subject>Deoxyribonucleic acid</subject><subject>Diagnosis</subject><subject>DNA</subject><subject>Early Diagnosis</subject><subject>Estimates</subject><subject>Exposure</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health facilities</subject><subject>Health services</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Seroprevalence</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Infectious Disease Transmission, Vertical</subject><subject>Laboratories</subject><subject>Medical care</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>People and Places</subject><subject>Physiological aspects</subject><subject>Population</subject><subject>Prenatal care</subject><subject>Prenatal Diagnosis</subject><subject>Quality management</subject><subject>Research and Analysis Methods</subject><subject>Rural Population</subject><subject>Serology</subject><subject>South Africa - epidemiology</subject><subject>Surveillance</subject><subject>Womens 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ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants</title><author>Chappell, Elizabeth ; Thorne, Claire ; Collins, Intira Jeannie ; Baisley, Kathy ; Yapa, H Manisha ; Gareta, Dickman ; Bärnighausen, Till ; Herbst, Kobus ; Judd, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c602t-2392b738b54fcfc21689793464fcec6feab81846ae196c8575d9dfadb4cfdb4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Algorithms</topic><topic>Babies</topic><topic>Biology and Life Sciences</topic><topic>Births</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Data sources</topic><topic>Delivery of Health Care</topic><topic>Demographic aspects</topic><topic>Deoxyribonucleic acid</topic><topic>Diagnosis</topic><topic>DNA</topic><topic>Early 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Dickman</au><au>Bärnighausen, Till</au><au>Herbst, Kobus</au><au>Judd, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>It ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-09-30</date><risdate>2021</risdate><volume>16</volume><issue>9</issue><spage>e0257496</spage><epage>e0257496</epage><pages>e0257496-e0257496</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Early infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-exposed infants in rural South Africa, between 2010-2016.
We estimated the proportion of infants ever tested (methods 1-3) and tested by 7 weeks of age (1-4) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with ≥1 EID result in routine laboratory surveillance; (2) the number of infants with ≥1 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with ≥1 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants' Road-to-Health-booklets.
The proportion ever tested was 43%, 88% and 138% for methods 1-3, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1-4 respectively.
The four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34591881</pmid><doi>10.1371/journal.pone.0257496</doi><tpages>e0257496</tpages><orcidid>https://orcid.org/0000-0002-5436-9386</orcidid><orcidid>https://orcid.org/0000-0003-1053-6434</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-09, Vol.16 (9), p.e0257496-e0257496 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2578156891 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Algorithms Babies Biology and Life Sciences Births Care and treatment Clinical trials Data sources Delivery of Health Care Demographic aspects Deoxyribonucleic acid Diagnosis DNA Early Diagnosis Estimates Exposure Gestational age Health aspects Health care Health facilities Health services HIV HIV (Viruses) HIV Infections - diagnosis HIV Infections - epidemiology HIV Seroprevalence Human immunodeficiency virus Humans Infant Infant, Newborn Infants Infectious Disease Transmission, Vertical Laboratories Medical care Medical diagnosis Medical research Medicine and Health Sciences Methods People and Places Physiological aspects Population Prenatal care Prenatal Diagnosis Quality management Research and Analysis Methods Rural Population Serology South Africa - epidemiology Surveillance Womens health |
| title | It ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T01%3A18%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=It%20ain't%20what%20you%20do,%20it's%20the%20way%20that%20you%20do%20it:%20The%20pitfalls%20of%20using%20routine%20data%20to%20measure%20early%20infant%20HIV%20diagnosis%20in%20HIV-exposed%20infants&rft.jtitle=PloS%20one&rft.au=Chappell,%20Elizabeth&rft.date=2021-09-30&rft.volume=16&rft.issue=9&rft.spage=e0257496&rft.epage=e0257496&rft.pages=e0257496-e0257496&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0257496&rft_dat=%3Cgale_plos_%3EA677376536%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2578156891&rft_id=info:pmid/34591881&rft_galeid=A677376536&rft_doaj_id=oai_doaj_org_article_293b48fe226742d682d317cd672253a0&rfr_iscdi=true |