Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa
Identifieur interne : 000743 ( Pmc/Curation ); précédent : 000742; suivant : 000744Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa
Auteurs : Ayesha Bm Kharsany ; Cherie Cawood ; David Khanyile ; Anneke Grobler ; Lyle R. Mckinnon ; Natasha Samsunder ; Janet A. Frohlich ; Quarraisha Abdool Karim ; Adrian Puren [Afrique du Sud] ; Alex Welte [Afrique du Sud] ; Gavin George [Afrique du Sud] ; Kaymarlin Govender [Afrique du Sud] ; Carlos Toledo [États-Unis] ; Zawadi Chipeta [Afrique du Sud] ; Lycias Zembe [Afrique du Sud] ; Mary T. Glenshaw [Afrique du Sud] ; Lorna Madurai [Afrique du Sud] ; Varough M Deyde [Afrique du Sud] ; Alfred Bere [Afrique du Sud]Source :
- BMC Public Health [ 1471-2458 ] ; 2015.
Abstract
South Africa has over 6,000,000 HIV infected individuals and the province of KwaZulu-Natal (KZN) is the most severely affected. As public health initiatives to better control the HIV epidemic are implemented, timely, detailed and robust surveillance data are needed to monitor, evaluate and inform the programmatic interventions and policies over time. We describe the rationale and design of the HIV Incidence Provincial Surveillance System (HIPSS) to monitor HIV prevalence and incidence.
The household-based survey will include a sample of men and women from two sub-districts of the uMgungundlovu municipality (Vulindlela and the Greater Edendale) of KZN, South Africa. The study is designed as two sequential cross-sectional surveys of 10,000 randomly selected individuals aged 15–49 years to be conducted one year apart. From the cross sectional surveys, two sequential cohorts of HIV negative individuals aged 15–35 years will be followed-up one year later to measure the primary outcome of HIV incidence. Secondary outcomes include the laboratory measurements for pulmonary tuberculosis, sexually transmitted infections and evaluating tests for estimating population-level HIV incidence.
Antiretroviral therapy (ART) access, HIV-1 RNA viral load, and CD4 cell counts in HIV positive individuals will assess the effectiveness of the HIV treatment cascade. Household and individual-level socio-demographic characteristics, exposure to HIV programmatic interventions and risk behaviours will be assessed as predictors of HIV incidence. The incidence rate ratio of the two cohorts will be calculated to quantify the change in HIV incidence between consecutive samples. In anticipation of better availability of population-level HIV prevention and treatment programmes leading to decreases in HIV incidence, the sample size provides 84 % power to detect a reduction of 30 % in the HIV incidence rate between surveys.
The results from HIPSS will provide critical data regarding HIV prevalence and incidence in this community and will establish whether HIV prevention and treatment efforts in a “real world”, non-trial setting have an impact on HIV incidence at a population level. Importantly, the study design and methods will inform future methods for HIV surveillance.
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DOI: 10.1186/s12889-015-2179-2
PubMed: 26588902
PubMed Central: 4654918
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Ayesha Bm Kharsany<affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa</title><author><name sortKey="Kharsany, Ayesha Bm" sort="Kharsany, Ayesha Bm" uniqKey="Kharsany A" first="Ayesha Bm" last="Kharsany">Ayesha Bm Kharsany</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Cawood, Cherie" sort="Cawood, Cherie" uniqKey="Cawood C" first="Cherie" last="Cawood">Cherie Cawood</name><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Khanyile, David" sort="Khanyile, David" uniqKey="Khanyile D" first="David" last="Khanyile">David Khanyile</name><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Grobler, Anneke" sort="Grobler, Anneke" uniqKey="Grobler A" first="Anneke" last="Grobler">Anneke Grobler</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Mckinnon, Lyle R" sort="Mckinnon, Lyle R" uniqKey="Mckinnon L" first="Lyle R." last="Mckinnon">Lyle R. Mckinnon</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Samsunder, Natasha" sort="Samsunder, Natasha" uniqKey="Samsunder N" first="Natasha" last="Samsunder">Natasha Samsunder</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Frohlich, Janet A" sort="Frohlich, Janet A" uniqKey="Frohlich J" first="Janet A" last="Frohlich">Janet A. Frohlich</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Abdool Karim, Quarraisha" sort="Abdool Karim, Quarraisha" uniqKey="Abdool Karim Q" first="Quarraisha" last="Abdool Karim">Quarraisha Abdool Karim</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Puren, Adrian" sort="Puren, Adrian" uniqKey="Puren A" first="Adrian" last="Puren">Adrian Puren</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg</wicri:regionArea></affiliation></author><author><name sortKey="Welte, Alex" sort="Welte, Alex" uniqKey="Welte A" first="Alex" last="Welte">Alex Welte</name><affiliation wicri:level="1"><nlm:aff id="Aff4">South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch</wicri:regionArea></affiliation></author><author><name sortKey="George, Gavin" sort="George, Gavin" uniqKey="George G" first="Gavin" last="George">Gavin George</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal</wicri:regionArea></affiliation></author><author><name sortKey="Govender, Kaymarlin" sort="Govender, Kaymarlin" uniqKey="Govender K" first="Kaymarlin" last="Govender">Kaymarlin Govender</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal</wicri:regionArea></affiliation></author><author><name sortKey="Toledo, Carlos" sort="Toledo, Carlos" uniqKey="Toledo C" first="Carlos" last="Toledo">Carlos Toledo</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Centres for Disease Control and Prevention (CDC) Atlanta, Atlanta, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC) Atlanta, Atlanta</wicri:regionArea></affiliation></author><author><name sortKey="Chipeta, Zawadi" sort="Chipeta, Zawadi" uniqKey="Chipeta Z" first="Zawadi" last="Chipeta">Zawadi Chipeta</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Zembe, Lycias" sort="Zembe, Lycias" uniqKey="Zembe L" first="Lycias" last="Zembe">Lycias Zembe</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Glenshaw, Mary T" sort="Glenshaw, Mary T" uniqKey="Glenshaw M" first="Mary T" last="Glenshaw">Mary T. Glenshaw</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Madurai, Lorna" sort="Madurai, Lorna" uniqKey="Madurai L" first="Lorna" last="Madurai">Lorna Madurai</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Global Clinical and Virology Laboratory, 11 Dan Pienaar Place, Amanzimtoti, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Global Clinical and Virology Laboratory, 11 Dan Pienaar Place, Amanzimtoti</wicri:regionArea></affiliation></author><author><name sortKey="M Deyde, Varough" sort="M Deyde, Varough" uniqKey="M Deyde V" first="Varough" last="M Deyde">Varough M Deyde</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Bere, Alfred" sort="Bere, Alfred" uniqKey="Bere A" first="Alfred" last="Bere">Alfred Bere</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26588902</idno><idno type="pmc">4654918</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654918</idno><idno type="RBID">PMC:4654918</idno><idno type="doi">10.1186/s12889-015-2179-2</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000744</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000744</idno><idno type="wicri:Area/Pmc/Curation">000743</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000743</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa</title><author><name sortKey="Kharsany, Ayesha Bm" sort="Kharsany, Ayesha Bm" uniqKey="Kharsany A" first="Ayesha Bm" last="Kharsany">Ayesha Bm Kharsany</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Cawood, Cherie" sort="Cawood, Cherie" uniqKey="Cawood C" first="Cherie" last="Cawood">Cherie Cawood</name><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Khanyile, David" sort="Khanyile, David" uniqKey="Khanyile D" first="David" last="Khanyile">David Khanyile</name><affiliation><nlm:aff id="Aff2">Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</nlm:aff><wicri:noCountry code="subfield">7620 Cape Town South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Grobler, Anneke" sort="Grobler, Anneke" uniqKey="Grobler A" first="Anneke" last="Grobler">Anneke Grobler</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Mckinnon, Lyle R" sort="Mckinnon, Lyle R" uniqKey="Mckinnon L" first="Lyle R." last="Mckinnon">Lyle R. Mckinnon</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Samsunder, Natasha" sort="Samsunder, Natasha" uniqKey="Samsunder N" first="Natasha" last="Samsunder">Natasha Samsunder</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Frohlich, Janet A" sort="Frohlich, Janet A" uniqKey="Frohlich J" first="Janet A" last="Frohlich">Janet A. Frohlich</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Abdool Karim, Quarraisha" sort="Abdool Karim, Quarraisha" uniqKey="Abdool Karim Q" first="Quarraisha" last="Abdool Karim">Quarraisha Abdool Karim</name><affiliation><nlm:aff id="Aff1">Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</nlm:aff><wicri:noCountry code="subfield">4013 Durban South Africa</wicri:noCountry></affiliation></author><author><name sortKey="Puren, Adrian" sort="Puren, Adrian" uniqKey="Puren A" first="Adrian" last="Puren">Adrian Puren</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg</wicri:regionArea></affiliation></author><author><name sortKey="Welte, Alex" sort="Welte, Alex" uniqKey="Welte A" first="Alex" last="Welte">Alex Welte</name><affiliation wicri:level="1"><nlm:aff id="Aff4">South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch</wicri:regionArea></affiliation></author><author><name sortKey="George, Gavin" sort="George, Gavin" uniqKey="George G" first="Gavin" last="George">Gavin George</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal</wicri:regionArea></affiliation></author><author><name sortKey="Govender, Kaymarlin" sort="Govender, Kaymarlin" uniqKey="Govender K" first="Kaymarlin" last="Govender">Kaymarlin Govender</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal</wicri:regionArea></affiliation></author><author><name sortKey="Toledo, Carlos" sort="Toledo, Carlos" uniqKey="Toledo C" first="Carlos" last="Toledo">Carlos Toledo</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Centres for Disease Control and Prevention (CDC) Atlanta, Atlanta, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC) Atlanta, Atlanta</wicri:regionArea></affiliation></author><author><name sortKey="Chipeta, Zawadi" sort="Chipeta, Zawadi" uniqKey="Chipeta Z" first="Zawadi" last="Chipeta">Zawadi Chipeta</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Zembe, Lycias" sort="Zembe, Lycias" uniqKey="Zembe L" first="Lycias" last="Zembe">Lycias Zembe</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Glenshaw, Mary T" sort="Glenshaw, Mary T" uniqKey="Glenshaw M" first="Mary T" last="Glenshaw">Mary T. Glenshaw</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Madurai, Lorna" sort="Madurai, Lorna" uniqKey="Madurai L" first="Lorna" last="Madurai">Lorna Madurai</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Global Clinical and Virology Laboratory, 11 Dan Pienaar Place, Amanzimtoti, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Global Clinical and Virology Laboratory, 11 Dan Pienaar Place, Amanzimtoti</wicri:regionArea></affiliation></author><author><name sortKey="M Deyde, Varough" sort="M Deyde, Varough" uniqKey="M Deyde V" first="Varough" last="M Deyde">Varough M Deyde</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author><author><name sortKey="Bere, Alfred" sort="Bere, Alfred" uniqKey="Bere A" first="Alfred" last="Bere">Alfred Bere</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centres for Disease Control and Prevention (CDC), Pretoria</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>South Africa has over 6,000,000 HIV infected individuals and the province of KwaZulu-Natal (KZN) is the most severely affected. As public health initiatives to better control the HIV epidemic are implemented, timely, detailed and robust surveillance data are needed to monitor, evaluate and inform the programmatic interventions and policies over time. We describe the rationale and design of the HIV Incidence Provincial Surveillance System (HIPSS) to monitor HIV prevalence and incidence.</p></sec><sec><title>Methods/Design</title><p>The household-based survey will include a sample of men and women from two sub-districts of the uMgungundlovu municipality (Vulindlela and the Greater Edendale) of KZN, South Africa. The study is designed as two sequential cross-sectional surveys of 10,000 randomly selected individuals aged 15–49 years to be conducted one year apart. From the cross sectional surveys, two sequential cohorts of HIV negative individuals aged 15–35 years will be followed-up one year later to measure the primary outcome of HIV incidence. Secondary outcomes include the laboratory measurements for pulmonary tuberculosis, sexually transmitted infections and evaluating tests for estimating population-level HIV incidence.</p><p>Antiretroviral therapy (ART) access, HIV-1 RNA viral load, and CD4 cell counts in HIV positive individuals will assess the effectiveness of the HIV treatment cascade. Household and individual-level socio-demographic characteristics, exposure to HIV programmatic interventions and risk behaviours will be assessed as predictors of HIV incidence. The incidence rate ratio of the two cohorts will be calculated to quantify the change in HIV incidence between consecutive samples. In anticipation of better availability of population-level HIV prevention and treatment programmes leading to decreases in HIV incidence, the sample size provides 84 % power to detect a reduction of 30 % in the HIV incidence rate between surveys.</p></sec><sec><title>Discussion</title><p>The results from HIPSS will provide critical data regarding HIV prevalence and incidence in this community and will establish whether HIV prevention and treatment efforts in a “real world”, non-trial setting have an impact on HIV incidence at a population level. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Public Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Public Health</journal-id><journal-title-group><journal-title>BMC Public Health</journal-title></journal-title-group><issn pub-type="epub">1471-2458</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26588902</article-id><article-id pub-id-type="pmc">4654918</article-id><article-id pub-id-type="publisher-id">2179</article-id><article-id pub-id-type="doi">10.1186/s12889-015-2179-2</article-id><article-categories><subj-group subj-group-type="heading"><subject>Study Protocol</subject></subj-group></article-categories><title-group><article-title>Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Kharsany</surname><given-names>Ayesha BM</given-names></name><address><phone>+27 31 2604558</phone><email>Ayesha.Kharsany@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Cawood</surname><given-names>Cherie</given-names></name><address><email>Cheriec@epicentre.org.za</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Khanyile</surname><given-names>David</given-names></name><address><email>Davidk@epicentre.org.za</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Grobler</surname><given-names>Anneke</given-names></name><address><email>Anneke.Grobler@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Mckinnon</surname><given-names>Lyle R.</given-names></name><address><email>Lyle.Mckinnon@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Samsunder</surname><given-names>Natasha</given-names></name><address><email>Natasha.Samsunder@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Frohlich</surname><given-names>Janet A</given-names></name><address><email>Janet.Frohlich@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Abdool Karim</surname><given-names>Quarraisha</given-names></name><address><email>Quarraisha.AbdoolKarim@caprisa.org</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Puren</surname><given-names>Adrian</given-names></name><address><email>adrianp@nicd.ac.za</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Welte</surname><given-names>Alex</given-names></name><address><email>alexwelte@sun.ac.za</email></address><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>George</surname><given-names>Gavin</given-names></name><address><email>Georgeg@ukzn.ac.za</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Govender</surname><given-names>Kaymarlin</given-names></name><address><email>Govenderk2@ukzn.ac.za</email></address><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Toledo</surname><given-names>Carlos</given-names></name><address><email>cot8@cdc.gov</email></address><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Chipeta</surname><given-names>Zawadi</given-names></name><address><email>chipetaz@sa.cdc.gov</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Zembe</surname><given-names>Lycias</given-names></name><address><email>xxc4@cdc.gov</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Glenshaw</surname><given-names>Mary T</given-names></name><address><email>fev5@cdc.gov</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Madurai</surname><given-names>Lorna</given-names></name><address><email>MLorna@GCVLABS.CO.ZA</email></address><xref ref-type="aff" rid="Aff8"></xref></contrib><contrib contrib-type="author"><name><surname>M Deyde</surname><given-names>Varough</given-names></name><address><email>che5@cdc.gov</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author"><name><surname>Bere</surname><given-names>Alfred</given-names></name><address><email>yek8@cdc.gov</email></address><xref ref-type="aff" rid="Aff7"></xref></contrib><aff id="Aff1"><label></label>Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd Floor, Private Bag 7, Congella, 4013 Durban South Africa</aff><aff id="Aff2"><label></label>Epicentre AIDs Risk Management (Pty) Limited, P O Box 3484, Paarl, 7620 Cape Town South Africa</aff><aff id="Aff3"><label></label>Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service (NICD/NHLS), Johannesburg, South Africa</aff><aff id="Aff4"><label></label>South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch, South Africa</aff><aff id="Aff5"><label></label>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, KwaZulu-Natal, South Africa</aff><aff id="Aff6"><label></label>Centres for Disease Control and Prevention (CDC) Atlanta, Atlanta, USA</aff><aff id="Aff7"><label></label>Centres for Disease Control and Prevention (CDC), Pretoria, South Africa</aff><aff id="Aff8"><label></label>Global Clinical and Virology Laboratory, 11 Dan Pienaar Place, Amanzimtoti, South Africa</aff></contrib-group><pub-date pub-type="epub"><day>20</day><month>11</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>20</day><month>11</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>15</volume><elocation-id>1149</elocation-id><history><date date-type="received"><day>20</day><month>7</month><year>2015</year></date><date date-type="accepted"><day>21</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>© Kharsany et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>South Africa has over 6,000,000 HIV infected individuals and the province of KwaZulu-Natal (KZN) is the most severely affected. As public health initiatives to better control the HIV epidemic are implemented, timely, detailed and robust surveillance data are needed to monitor, evaluate and inform the programmatic interventions and policies over time. We describe the rationale and design of the HIV Incidence Provincial Surveillance System (HIPSS) to monitor HIV prevalence and incidence.</p></sec><sec><title>Methods/Design</title><p>The household-based survey will include a sample of men and women from two sub-districts of the uMgungundlovu municipality (Vulindlela and the Greater Edendale) of KZN, South Africa. The study is designed as two sequential cross-sectional surveys of 10,000 randomly selected individuals aged 15–49 years to be conducted one year apart. From the cross sectional surveys, two sequential cohorts of HIV negative individuals aged 15–35 years will be followed-up one year later to measure the primary outcome of HIV incidence. Secondary outcomes include the laboratory measurements for pulmonary tuberculosis, sexually transmitted infections and evaluating tests for estimating population-level HIV incidence.</p><p>Antiretroviral therapy (ART) access, HIV-1 RNA viral load, and CD4 cell counts in HIV positive individuals will assess the effectiveness of the HIV treatment cascade. Household and individual-level socio-demographic characteristics, exposure to HIV programmatic interventions and risk behaviours will be assessed as predictors of HIV incidence. The incidence rate ratio of the two cohorts will be calculated to quantify the change in HIV incidence between consecutive samples. In anticipation of better availability of population-level HIV prevention and treatment programmes leading to decreases in HIV incidence, the sample size provides 84 % power to detect a reduction of 30 % in the HIV incidence rate between surveys.</p></sec><sec><title>Discussion</title><p>The results from HIPSS will provide critical data regarding HIV prevalence and incidence in this community and will establish whether HIV prevention and treatment efforts in a “real world”, non-trial setting have an impact on HIV incidence at a population level. Importantly, the study design and methods will inform future methods for HIV surveillance.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa
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