Feasibility of measuring HIV-related mortality during population-based surveys in Africa

在非洲基于人口的调查中衡量艾滋病毒相关死亡率的可行性

基本信息

批准号：
9204150
负责人：
Stephane Helleringer
金额：
$ 23.5万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-23 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9204150
关键词：
AIDS prevention AIDS/HIV problem Accidents Acquired Immunodeficiency Syndrome Address Adult Affect Africa Africa South of the Sahara African Anti-Retroviral Agents Autopsy Caring Cause of Death Cessation of life Classification Clinic Clinical Code Communication Computer Assisted Country Data Data Quality Data Set Date of birth Demographic and Health Surveys Disclosure Disease Effectiveness Epidemic Evaluation Excess Mortality Garbage Generations Goals HIV Health Hospitals Household Human Resources Human immunodeficiency virus test Income Individual Institutes International International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)Intervention Interview Interviewer Investigation Knowledge Lesotho Life Logit Models Malawi Maternal Mortality Measures Methodology Modeling Monitor Nomads Operating System Patients Persons Population Prevalence Prevention program Process Qualitative Research Questionnaires ROC Curve Randomized Records Reporting Respondent Rural Population Sampling Sensitivity and Specificity Siblings Social Network Surveys System Testing Vision Visit base cohort comparative cost follow-up improved instrument mathematical model member mortality population based primary outcome programs randomized trial success treatment program trend validation studies

项目摘要

PROJECT ABSTRACT Every year, large amounts of financial and human resources are invested in addressing HIV epidemics worldwide. Reducing HIV/AIDS deaths is one of the clearest indicators of success in these HIV prevention and treatment programs. It is thus crucial to collect the best possible data on HIV/AIDS mortality to 1) monitor progress towards this target and 2) evaluate the impact of HIV programs. Unfortunately, the vast majority of countries most affected by HIV epidemics, in particular those located in Sub-Saharan Africa (SSA), often lack well-functioning civil registration and disease surveillance systems (CRS). Instead, reliable data on causes of death in SSA are currently only available for small and highly selected populations. We propose to address this lack of representative data by assessing the feasibility of collecting information on HIV mortality during household surveys such as the Demographic and Health Surveys (DHS). These data constitute the primary input used by international organizations to estimate all-cause mortality in SSA countries with limited CRS. They measure mortality by asking a random sample of respondents to report the date of birth and (possibly) death of each of their close relatives (e.g., siblings). They frequently also include an assessment of other causes of death such as maternal mortality and accidents, but they do not currently collect data on HIV mortality. We will thus enhance the adult mortality questionnaire used by the DHS with 3-5 direct questions on i) the HIV status and ii) the engagement in HIV care and treatment of each reported deceased relative. We will develop this enhanced questionnaire through a participatory process of qualitative research (aim 1). We will then measure the accuracy of this questionnaire in recording HIV deaths during a retrospective validation study against reference data on HIV mortality from a health and demographic surveillance system in Malawi (aims 2 & 3). A nested randomized sub-study will also determine whether the use of audio computer-assisted self- interviewing (ACASI) can help further improve the reporting of HIV deaths during mortality surveys. If accurate, this enhanced questionnaire will yield direct estimates of the excess mortality faced by persons living with HIV in a country. This promises to significantly strengthen the evaluation of HIV care and treatment programs in SSA, and to improve our understanding of the HIV care cascade.

项目摘要每年投入大量财力和人力资源应对艾滋病流行全世界。减少艾滋病毒/艾滋病死亡是艾滋病毒预防和治疗工作取得成功的最明显指标之一。治疗方案。因此，收集有关艾滋病毒/艾滋病死亡率的最佳数据至关重要：1) 监测实现这一目标的进展；2) 评估艾滋病毒项目的影响。不幸的是，绝大多数受艾滋病毒流行影响最严重的国家，特别是位于撒哈拉以南非洲（SSA）的国家，往往缺乏运作良好的民事登记和疾病监测系统（CRS）。相反，有关原因的可靠数据目前，SSA 的死亡情况仅适用于少量且经过精心挑选的人群。我们建议解决这个问题通过评估收集艾滋病毒死亡率信息的可行性，缺乏代表性数据家庭调查，例如人口统计和健康调查 (DHS)。这些数据构成了主要数据国际组织用于估计 CRS 有限的撒哈拉以南非洲国家全因死亡率的信息。他们通过要求随机抽样的受访者报告出生日期和（可能）来衡量死亡率他们每个近亲（例如兄弟姐妹）的死亡。它们通常还包括对其他方面的评估孕产妇死亡和事故等死亡原因，但他们目前不收集艾滋病毒数据死亡。因此，我们将通过 3-5 个直接问题来增强国土安全部使用的成人死亡率调查问卷 i) HIV 状况，以及 ii) 每个报告的已故亲属参与 HIV 护理和治疗的情况。我们将通过参与性的定性研究过程（目标 1）制定这份强化问卷。我们将然后在回顾性验证研究中衡量该问卷在记录艾滋病毒死亡方面的准确性对照来自马拉维健康和人口监测系统的艾滋病毒死亡率参考数据（目标 2 ＆3）。嵌套随机子研究还将确定是否使用音频计算机辅助自助访谈 (ACASI) 有助于进一步改善死亡率调查期间艾滋病毒死亡的报告。如果准确的话该增强版调查问卷将直接估计艾滋病毒感染者所面临的超额死亡率在一个国家。这有望显着加强对艾滋病毒护理和治疗项目的评估 SSA，并提高我们对艾滋病毒护理级联的了解。