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Enhancing HIV Response: Case-Based Surveillance in Zambia

Explore the implementation of HIV Case-Based Surveillance in Zambia as per UNAIDS & WHO guidelines. Learn about its components, benefits, and importance in tracking and managing HIV cases effectively.

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Enhancing HIV Response: Case-Based Surveillance in Zambia

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  1. Republic of ZambiaMinistry of HealthHIV CASE BASED SURVEILLANCE Implementation in Zambia

  2. Overview of HIV Case Based Surveillance

  3. Overview of HIV Case Based Surveillance • UNAIDS & WHO recommend case surveillance as part of a comprehensive system of 2ndGeneration Surveillance. • 2ndGeneration HIV Surveillance is designed to help countries: • Concentrate SI resources where they will yield the greatest impact. • Make the best use of existing data to increase understanding of the HIV epidemic and the behaviors that spread it. • HIV case reporting is one of the key components of HIV surveillance.

  4. WHO Latest Guidelines on HIV Case Based Surveillance

  5. What is HIV Case Based Surveillance? • A method used to capture routinely generated individual-level information on PLWHIV; • Each individual living with HIV is reported using a single case report containing information pertaining only to that person; • The record is longitudinal allowing the addition of care and treatment outcomes; • Thus, HIV CBS monitors the entire spectrum of the disease from diagnosis to death. HIVCase Surveillance:Refers to the systematic reporting and analysis of standardized information about cases diagnosed with HIV to an agency responsible (MoH) for HIV Prevention, Control and Action.

  6. Why HIV Case Based Surveillance?.... • It leverages existing routinely collected data and it be integrated into existing reporting systems; • It provides de-duplicated individual-level data on diagnosed PLWHIV from across the health care system; • Provides up-to-date epidemiological and service data for decision making and program management; • Provides data that is disaggregated by age, sex, geographic, demographic and risk category; • It is sustainable.

  7. Why implement HIV CBS now? • Entered the treatment era with potential to stop transmission; • Measure progress towards Global (UNAIDS)90-90-90 targets; and • Provides data at sub-national and national levels.

  8. Components of the HIV CBS

  9. Components of HIV Case Surveillance What will be reported? • New HIV infection • Advanced stage HIV disease (stages 3, 4) Date and location of HIV dx, patient demographic info, risk factors, tx referral date and facility. Events to be reported (Longitudinal Clinical Outcomes)? • 1st HIV Positive Test • 1stViral Load Test • All viral loads (tracking cases) • 1stCD4+ test • All CD4+ tests (tracking cases) • Drug pick ups, Loss to follow-up Date and facility of entry to care, Date ART started and tx regimen, CD4 results, VL results, pregnancy status, patient death, date of all clinical visits

  10. Links Between HIV Patient Monitoring and Case Based In Comprehensive Strategic System for HIV Uses of CBS: • To effectively monitor trends in prevalent HIV infection; • To characterize the affected populations; • To identify the number of persons in need of care and treatment; • To allocate care, treatment and prevention resources; • To target and evaluate intervention and prevention programs; and • To provide a context for M&E data. *WHO- Consolidated Guidelines on Person Centered on HIV Monitoring and Case Surveillance June 2017

  11. Data Sources and Variables for HIV CBS

  12. Key Data Sources Required To Report The Cascade Services Registers /Records: OPD IPD HTS HIV Care and Treatment STI Integrated MCH 0-23 and 24-59 months Integrated FP VMMC PrEP and PEP Laboratory Pharmacy HEI SmartCare DHIS 2.0

  13. Minimum Variables for Case Reporting Note: There are Seven minimum sentinel events for CBS

  14. Implementation of HIV CBS in Zambia

  15. CBS and Patient Monitoring : SWOT Analysis Results

  16. CBS: Priority Action Plan

  17. CBS Dash Board: Priority Action Plan

  18. Implementation Phases and Current Status • First Phase (Testing) - 24 health facilities in Livingstone District; • Second Phase - 25 districts with high HIV/AIDS burden; • Third Phase - The rest of the country.

  19. Summary – The Data 90s • National Impact – 90% of fast track programs evaluated causatively for impact on incidence and mortality, using data and some modeling; • Sub-national: 90% of districts have routine, real time district data on testing, treatment and viral load with analyst capacity to feed back to programs; • Individual M & E: 90% of patients covered by robust, secure patient monitoring and case surveillance from testing to outcomes.

  20. Data is really an intervention! “We have counted numbers, but patients are people, and we need to measure and support them as people with our data, if we can do that it will go along way to tackling the HIV problem” Dr. David Okello, WR, Zimbabwe

  21. Thank You

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