title: Test uptake and case detection of syphilis, HIV, and hepatitis C among women undergoing prenatal screening in British Columbia, 2007 to 2011.
abstract: OBJECTIVE
  Test uptake and case detection trends for rubella, syphilis, HIV, and hepatitis C (HCV) were compared among the 2007 to 2011 cohort of women undergoing prenatal testing in British Columbia. Analysis involved linkage of provincially centralized laboratory and surveillance data to assess prenatal test uptake and rates of newly diagnosed versus prevalent infections.
  
  
  METHODS
  We included prenatal specimens submitted from BC women aged 16 to 45 years in 2007 to 2011. Laboratory records were linked to provincial surveillance systems to identify confirmed maternal syphilis and HIV cases. Previous positive status was determined for HIV and HCV if a prior confirmed case was identified from laboratory records. We determined rates of HIV and HCV newly identified at prenatal screening (new diagnoses per 100 000 per year). Prevalence for HIV and HCV was the sum of all new and prior diagnoses (prevalence per 100 000 per year).
  
  
  RESULTS
  Of 233 203 women, 96.9% were screened for rubella, 93.3% for syphilis, 93.8% for HIV, and 21.5% for HCV. From 2007 to 2011, the overall rates of new diagnoses were 15.4, 5.1, and 82.8 cases per 100 000 per year for syphilis, HIV, and HCV, respectively. The overall prevalence was 45.9 and 551.5 cases per 100 000 per year for HIV and HCV, respectively (0.05% and 0.6%). From 2007 to 2011, new diagnoses of HCV decreased 40% from 106.0 to 62.1 cases per 100 000 per year. HCV prevalence did not change and increased with maternal age.
  
  
  CONCLUSIONS
  This study links surveillance and laboratory data to provide a provincial picture of prenatal screening test uptake and case detection, with the advantage of distinguishing new from prior diagnoses. This information can help guide prenatal communicable disease screening policy.
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC.
authors.forename: Margot
authors.initials: M
authors.lastname: Kuo
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia BC Women's Hospital, Vancouver BC; Women's Health Research Institute, Vancouver BC.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC.
authors.forename: Maria
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC; School of Population and Public Health, University of British Columbia, Vancouver BC.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver BC.
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC; Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver BC.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Lester
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC; Faculty of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.affiliation: British Columbia Centre for Disease Control, Vancouver BC; School of Population and Public Health, University of British Columbia, Vancouver BC.
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D015995:Prevalence; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
keywords: HIV; data linkage; hepatitis C; prenatal; prevalence; rubella; screening; syphilis