title: Has the quality of serosurveillance in low- and middle-income countries improved since the last HIV estimates round in 2007? Status and trends through 2009.
abstract: BACKGROUND
  HIV surveillance systems aim to monitor trends of HIV infection, the geographical distribution and its magnitude, and the impact of HIV. The quality of HIV surveillance is a key element in determining the uncertainty ranges around HIV estimates. This paper aims to assess the quality of HIV surveillance systems in low- and middle-income countries in 2009 compared with 2007.
  
  
  METHODS
  Four dimensions related to the quality of surveillance systems are assessed: frequency and timeliness of data; appropriateness of populations; consistency of locations and groups; and representativeness of the groups. An algorithm for scoring the quality of surveillance systems was used separately for low and concentrated epidemics and for generalised epidemics.
  
  
  RESULTS
  The number of countries categorised as fully functioning in 2009 was 35, down from 40 in 2007. 47 countries were identified as partially functioning, while 56 were categorised as poorly functioning. When compared with 2007, the quality of HIV surveillance remains similar. The number of ANC sites in sub-Saharan Africa has increased over time. The number of countries with low and concentrated epidemics that do not have functioning HIV surveillance systems has increased from 53 to 56 between 2007 and 2009.
  
  
  CONCLUSIONS
  Overall, the quality of surveillance in low- and middle-income countries has remained stable. Still too many countries have poorly functioning surveillance systems. Several countries with generalised epidemics have conducted more than one population-based survey which can be used to confirm trends. In countries with concentrated or low-level epidemics, the lack of data on high-risk populations remains a challenge.
authors.affiliation: World Health Organization, 20 Avenue Appia, Geneva 27, Switzerland. callejaj@who.int
authors.forename: Jesus M
authors.initials: JM
authors.lastname: García Calleja
authors.forename: J
authors.initials: J
authors.lastname: Jacobson
authors.forename: R
authors.initials: R
authors.lastname: Garg
authors.forename: N
authors.initials: N
authors.lastname: Thuy
authors.forename: A
authors.initials: A
authors.lastname: Stengaard
authors.forename: M
authors.initials: M
authors.lastname: Alonso
authors.forename: H O
authors.initials: HO
authors.lastname: Ziady
authors.forename: L
authors.initials: L
authors.lastname: Mukenge
authors.forename: S
authors.initials: S
authors.lastname: Ntabangana
authors.forename: D
authors.initials: D
authors.lastname: Chamla
authors.forename: A
authors.initials: A
authors.lastname: Alisalad
authors.forename: E
authors.initials: E
authors.lastname: Gouws
authors.forename: K
authors.initials: K
authors.lastname: Sabin
authors.forename: Y
authors.initials: Y
authors.lastname: Souteyrand
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection / Q000592:standards* / Q000639:trends; D003906:Developing Countries / Q000706:statistics & numerical data*; D058872:Epidemics / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D012107:Research Design; D018571:Sentinel Surveillance; D055815:Young Adult