title: Sentinel surveillance for HIV-1 among pregnant women in a developing country: 3 years' experience and comparison with a population serosurvey.
abstract: OBJECTIVE
  To establish unlinked, anonymous sentinel surveillance for HIV-1 among pregnant women attending an antenatal clinic, to determine age-specific seroprevalences, to monitor trends and to compare seroprevalence with that detected by a population serosurvey. To establish the sustainability and costs of surveillance.
  
  
  METHODS
  Sentinel surveillance for HIV through serial collection of unlinked, anonymous seroprevalence data from antenatal care; comparison of sentinel data with those from a population serosurvey; financial and general audit of the sentinel surveillance.
  
  
  METHODS
  A community antenatal clinic in a large urban centre, Mwanza Municipality, Tanzania, eastern Africa, between October 1988 and September 1991.
  
  
  METHODS
  Pregnant women attending for antenatal care.
  
  
  METHODS
  Age-specific HIV-1 seroprevalences, trends over time, difference from age-specific population seroprevalences, sustainability and costs.
  
  
  RESULTS
  Overall HIV-1 seroprevalence was 11.5% (95% confidence interval, 10.5-12.4); differences in age-specific prevalences were not significant. There was no clear evidence of change in seroprevalence over the study period in any age group, although there was some indication of a rise in some age groups in 1988-1989. Sentinel surveillance among pregnant women may have significantly underestimated population HIV-1 seroprevalence for women under the age of 35 years. HIV-1 surveillance proved feasible and sustainable. Additional recurrent costs were US$1.7 per specimen for unlinked anonymous testing and US$0.57 per woman for syphilis screening.
  
  
  CONCLUSIONS
  HIV-1 seroprevalence did not change significantly over 3 years, probably implying a substantial incidence of HIV-1 infection. In this setting seroprevalence in pregnant women may have underestimated population seroprevalence in women aged under 35 years. With modest inputs and good organization unlinked anonymous HIV-1 sentinel surveillance of pregnant women can be introduced and sustained in an African setting. This may usefully be carried out in conjunction with syphilis screening.
authors.affiliation: Office of the Regional Commissioner, Mwanza.
authors.forename: R M
authors.initials: RM
authors.lastname: Kigadye
authors.forename: A
authors.initials: A
authors.lastname: Klokke
authors.forename: A
authors.initials: A
authors.lastname: Nicoll
authors.forename: K M
authors.initials: KM
authors.lastname: Nyamuryekung'e
authors.forename: M
authors.initials: M
authors.lastname: Borgdorff
authors.forename: L
authors.initials: L
authors.lastname: Barongo
authors.forename: U
authors.initials: U
authors.lastname: Laukamm-Josten
authors.forename: F
authors.initials: F
authors.lastname: Lisekie
authors.forename: H
authors.initials: H
authors.lastname: Grosskurth
authors.forename: F
authors.initials: F
authors.lastname: Kigadye
mesh_terms: D015492:AIDS Serodiagnosis / Q000191:economics / Q000379:methods; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D003906:Developing Countries / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D017408:Guidelines as Topic; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D015528:HIV Seroprevalence / Q000639:trends; D015497:HIV-1; D015498:HIV-2; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control; D013587:Syphilis / Q000453:epidemiology / Q000517:prevention & control; D013588:Syphilis Serodiagnosis / Q000191:economics; D013636:Tanzania / Q000453:epidemiology; D014505:Urban Population; D014944:World Health Organization
chemical_list: D015483:HIV Antibodies