Evaluation of the HIV/AIDS Epidemiological Surveillance System, Nouakchott Outpatient Treatment Center, Mauritania: Research Article

Mohamedou HMEIED MAHAM; Pauline Kiswendsida YANOGO; Djibril BARRY; Yoda HERMANN; Abdarrahmane BAYE; Nicolas MEDA

doi:10.58372/2835-6276.1267

Authors

Mohamedou HMEIED MAHAM
Pauline Kiswendsida YANOGO
Djibril BARRY
Yoda HERMANN
Abdarrahmane BAYE
Nicolas MEDA

DOI:

https://doi.org/10.58372/2835-6276.1267

Keywords:

Evaluation, Surveillance, HIV/AIDS, Mauritania

Abstract

Background: HIV/AIDS continues to be a public health problem and a major global concern. West and Central Africa had 4.9 million cases in 2019, including 240,000 new cases and about 140,000 deaths related to HIV/AIDS. In Mauritania, in 2019, according to WHO estimates, the prevalence of HIV/AIDS is estimated at 0.2%. We evaluated the HIV/AIDS surveillance system in the Nouakchott region to describe its organization and functioning, determine its usefulness, and assess its attributes according to the updated guidelines of the Center for Disease Control and Prevention for the evaluation of public health surveillance systems.

Methods: This descriptive cross-sectional study was conducted from May 1st, 2020, to December 2020 and involved data from January 2019 to December 2019. The study population consisted of actors directly involved in surveillance at all levels of the country's surveillance system. Data were collected through document review and semi-structured interviews. Data analysis was done using Epi Info® 7.2.5.6 and Excel®2020. Proportions and rates were calculated. The characteristics were assessed by estimating the average of the results obtained on each variable.

Results: The monitoring system is complex but useful, achieving its objectives. An average utility level of 52% was noted, with a 95% confidence interval (CI) [16 – 85%]. The average simplicity was 64%, CI [33-94%]. The performance level in terms of flexibility was 47%, CI [16 - 77%]. Similarly, the level of performance regarding acceptability was 47%, CI [21 – 70%]. Average responsiveness was 65%, CI [39 – 89%]. The Positive Predictive Value (96.24%) was high in 2019.

Conclusions: The monitoring system was found to be useful and met its objectives. Flexibility and acceptability need to be improved. We recommend to the national AIDS program to establish other HIV/AIDS testing centers and outpatient treatment centers at the districts and regional levels, at the DRS, it is recommended to regularly supervise surveillance activities in the districts and to organize quarterly health training. For the CTA of Nouakchott, it is advisable to strengthen collaboration with the DRS and INRSP for the screening of suspected cases of HIV/AIDS in non-hospitalized patients.

References

Saindou, Maoulide. Prevalence and determinants of sexually transmitted infections among pregnant women in Mayotte: an epidemiological study concerning the human immunodeficiency virus, the hepatitis B virus and the Treponema pallidum virus [Internet] [phdthesis]. Claude Bernard University - Lyon I; 2013 [cited 2020 Mar 10]. Available from: https://theses.hal.science/tel-01174741

Karakodjo, Dene Edith. Monitoring of the biological parameters of PLHIV on ARV treatment at the EPH in Gao. Pharmacy thesis, Faculty of Medicine, Pharmacy and Odontostomatology, USTTB. 2011 P6 [Internet]. University of Science, Technology and Technology of Bamako; 2011 [cited 2023 May 10]. Available from: https://www.bibliosante.ml/handle/123456789/1846

UNAIDS 2020. AIDS World Update Report 2020 [Internet]. 2020 [cited 2020 Mar 5]. Available from: https://www.google.com/search?q=ONUSIDA+2020

UNAIDS 2020. National Progress Reports - Mauritania, Global AIDS Progress Report 2020).pdf [Internet]. [cited 2020 Mar 10]. Available from: https://www.unaids.org/sites/default/files/country/documents/MRT_2020_countryreport.pdf

Werle JE, Teston EF, Rossi RM, Frota OP, Ferreira Júnior MA, Cunha GH da, Marcon SS, Sato DM. Factors associated with death due to HIV/AIDS. Acta paul enferm. 2022 Dec 12; 35:eAPE02837.

Sabapathy K, Hensen B, Varsaneux O, Floyd S, Fidler S, Hayes R. The cascade of care following community-based detection of HIV in sub-Saharan Africa – A systematic review with 90-90-90 targets in sight. PLOS ONE. 2018 Jul 27; 13(7):e0200737.

Mauritania - Decree No. 027-2003 of 24 March 2003 establishing the National Committee to Combat HIV/AIDS and the Regional Committees to Combat HIV/AIDS. [Internet]. [cited 2020 Mar 10]. Available from: http://ilo.org/dyn/natlex/natlex4.detail?p_lang=fr&p_isn=66056

Technical Guide for Integrated Disease Surveillance and Response in the African Region: Third Edition | WHO | Regional Office for Africa [Internet]. 2024 [cited 2024 Dec 11]. Available from: https://www.afro.who.int/fr/publications/guide-technique-pour-la-surveillance-integree-de-la-maladie-et-la-riposte-dans-la

Yang L, Weston C, Cude C, Kincl L. Evaluating Oregon’s occupational public health surveillance system based on the CDC updated guidelines. Am J Ind Med. 2020 Aug; 63(8):713–25.

Groseclose SL, Buckeridge DL. Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation. Annu Rev Public Health. 2017 Mar 20; 38:57–79.

George J, Häsler B, Mremi I, Sindato C, Mboera L, Rweyemamu M, Mlangwa J. A systematic review on integration mechanisms in human and animal health surveillance systems with a view to addressing global health security threats. One Health Outlook. 2020 Jun 8; 2(1):11.

Desclaux A. Emergency, precariousness and the fight against HIV/AIDS in Africa. 1997; 1–166.

Bulletin de Surveillance Epidémiologique VIHSida No 5.pdf [Internet]. [cited 2024 Dec 11]. Available from: https://www.mspp.gouv.ht/site/downloads/Bulletin%20de%20Surveillance%20Epid%C3%A9miologique%20VIHSida%20No%205.pdf

Epidemiological surveillance of HIV/AIDS [Internet]. [cited 2024 Dec 11]. Available from: https://bibliosante.ml/bitstream/handle/123456789/6785/04P19.pdf?sequence=1

Awini EA, Bonney JHK, Frimpong JA, Ampofo WK, Koram KA. Information gaps in surveillance data and effects on the Ghanaian response to the Ebola outbreak in West Africa. Ghana Med J. 2017 Sep; 51(3):115–9.