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Impact of incomplete coverage of neonatal dried blood spot screening on estimating HIV-1 seroprevalence

Published online by Cambridge University Press:  15 May 2009

E. J. Hutchinson ,
A. Streetly ,
C. Grant ,
R. Pollitt ,
P. Eldridge  and
A. Nicoll
E. J. Hutchinson
Affiliation:
Public Health Laboratory Service Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
A. Streetly
Affiliation:
Guy's and St Thomas's Medical and Dental School (UMDS)
C. Grant
Affiliation:
Guy's and St Thomas's Medical and Dental School (UMDS)
R. Pollitt
Affiliation:
Neonatal Screening Laboratory, The Children's Hospital, Sheffield
P. Eldridge
Affiliation:
Department of Clinical Chemistry, Lewisham Hospital, NHS Trust
A. Nicoll
Affiliation:
Public Health Laboratory Service Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
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Summary

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The aim of this study was to determine the extent to which selective under-coverage of births to mothers more likely to be at risk of HIV-1 infection will result in a significant underestimation of the true neonatal seroprevalence. Census data, local birth statisties, maternity data and data from the prevalence monitoring programme were used to produce a model to predict the effects of under-coverage in the uptake of neonatal metabolic screening which has been observed in babies with a mother of ethnic group black African. The adjustment factor which allows for under-coverage is the relative inclusion ratio (RIR); the probability that samples from a group at different risk of HIV infection were included in the survey divided by the probability of inclusion for samples from all other babies. The RIR was found to be close to unity (0·97), indicating a minimal bias. Under usual conditions only if the relative inclusion ratio (RIR) declined to values of 0·87 or below would there be a substantial bias. Despite some selective under representation, the results obtained from the Unlinked Anonymous HIV Monitoring Programme Dried Blood Spot Survey would seem to identity levels of prevalence in the population of child-bearing women with a good degree of accuracy and remains a useful tool for resource allocation, planning of services, provision of care and counselling.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 1 , August 1996 , pp. 173 - 177
Copyright
Copyright © Cambridge University Press 1996

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