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Guidelines for Assessing the Utility of Data from Prevention of Mother-to-Child Transmission (PMTCT) Programs for HIV Sentinel Surveillance Among Pregnant Women

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Geneva, WHO, 2013

This document provides guidance to countries for assessing the utility of data from programmes for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) for HIV sentinel surveillance (HSS) among pregnant women. The objectives of these guidelines are as follows:
1. Describe the context and rationale for transitioning from traditional HSS based on unlinked anonymous testing (UAT) in antenatal clinics (ANCs) to a system of HSS based on routine PMTCT programme data.
2. Describe robust methods for assessing the quality of PMTCT programme data for use in HSS.
3. Describe general standards for evaluating the readiness of PMTCT programme data to serve as the basis for HSS among pregnant women.

This information is provided in the form of general principles and standards to guide local discussions among the technical body charged with directing the assessment, including government public health actors, partners and subject matter experts. Though not strict targets, the suggested general standards presented in this document represent a high level of programme performance, which may serve as a point of reference to aid countries in interpreting assessment results.

For the purpose of these guidelines, the term “ANC HSS” will be used to refer to traditional periodic serosurveys of pregnant women at sentinel sites based on UAT, while “PMTCT-based HSS” will refer to HSS among pregnant women using routinely collected information from PMTCT programme records as its data source. “PMTCT data” refers to routinely collected data at sites that offer PMTCT programmes, and “PMTCT surveillance assessment” refers to assessment of the utility of data from PMTCT programmes for HSS.

A description of the methods and implementation of PMTCT-based HSS is beyond the scope of this document. However, a brief discussion on this topic is provided for the purpose of informing and planning the PMTCT surveillance assessment. This guidance document is written for national HIV/acquired immunodeficiency syndrome (AIDS) programme managers, surveillance officers and epidemiologists responsible for monitoring HIV trends in low- and middle-income countries.