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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

References

1.Dondero, TJ, Gill, ON. Large scale HIV serological surveys: what has been learned? AIDS 1991; 5 (suppl 2): S63–9.CrossRefGoogle ScholarPubMed
2.Ades, AE, Parker, S, Berry, T, et al. Prevalence of maternal HIV-1 infection in Thames Regions: results from anonymous unlinked neonatal testing. Lancet 1991; 337: 1562–5.CrossRefGoogle ScholarPubMed
3.Unlinked Anonymous HIV Surveys Steering Group. Unlinked anonymous HIV prevalence monitoring programme in England and Wales. Department of Health PHLS. Institute of Child Health (London), 1995.Google Scholar
4.Tappin, DM, Girdwood, RWA, Follett, EAC, Kennedy, R, Brown, AJ, Cockburn, F. Prevalence of maternal HIV infection in Scotland based on unlinked anonymous testing of newborn babies. Lancet 1991; 337: 1565–7.Google ScholarPubMed
5.Nicoll, A, Hutchinson, E, McGarrigle, C, et al. Survey of HIV infection among pregnant women in England and Wales: results of the first four years (1990–1993). Communicable Disease Report 1994; 4: R115–20.Google Scholar
6.Ades, AE, Davidson, CF, Holland, FJ, et al. Vertically transmitted HIV infection in the British Isles. BMJ 1993; 306: 1296–8.CrossRefGoogle ScholarPubMed
7.Holland, FJ, Ades, AE, Davidson, CF, et al. Use of anonymous newborn serosurveys to evaluate antenatal HIV screening programmes. J Med Screening 1994; 1: 176–9.CrossRefGoogle ScholarPubMed
8.Dunn, D, Nicoll, A, Holland, FJ, Davidson, CF. How much paediatric infection could be prevented by antenatal HIV testing. B J Med Screening 1995; 2: 35–40.CrossRefGoogle ScholarPubMed
9.Centers for Disease control. National HIV serosurveillance summary. Results through 1992. US Department of Health and Human Services, Public Health Service 1993; HIV/NCID/11-93/036.Google Scholar
10.Pappaioanou, M, Kashamuka, M, Behets, F. Accurate detection of maternal antibodies to HIV in newborn whole blood dried on filter paper. AIDS 1993; 7: 483–8.CrossRefGoogle ScholarPubMed
11.Smith, I, Cook, B, Beasley, M. Review of neonatal screening programme for phenylketonuria. BMJ 1991; 303: 333–6.CrossRefGoogle ScholarPubMed
12.Grant, DB, Smith, I. Survey of neonatal screening for primary hyperthyroidism in England, Wales and Northern lreland 1982–4. BMJ 1988; 296: 1355–8.CrossRefGoogle Scholar
13.Streetly, A, Grant, C, Pollitt, RJ, Addison, GM. Survey of scope of neonatal screening in the United Kingdom. BMJ 1995; 311: 726.CrossRefGoogle ScholarPubMed
14.Pharoah, PD, Madden, MP. Audit of screening for congenital hyperthyroidism. Arch Dis Child 1992; 67: 1073–6.CrossRefGoogle Scholar
15.Elliman, DS, Garner, J. Review of neonatal screening programme for PKU. BMJ 1991; 303: 471.CrossRefGoogle Scholar
16.Streetly, A, Grant, C, Bicker, G, Eldridge, G, Bird, S, Griffiths, W. Variation in coverage by ethnic group of neonatal (Guthrie) screening programme in South London. BMJ 1994; 309: 372–4.CrossRefGoogle ScholarPubMed
17.Ades, AE. Serial HIV seroprevalence surveys: interpretations, design and role in HIV/AIDS prediction. Acquir Imm Defic Synd Hum Retrovirol 1995; 9: 490–9.Google ScholarPubMed
18.PHLS AIDS Centre and the Scottish Centre for Infection and Environmental Health. AIDS/HIV quarterly unpublished surveillance tables. No 24. Data to end Dec 1994.Google Scholar
19.Pass, KA, Schedlbaurer, LM, MacCubbin, PA, Glebatis, DM. Comparison of newborn screening records and birth certificates to estimate bias in newborn HIV serosurveys. Am J Public Health 1991; 81 (suppl): 22–4.CrossRefGoogle ScholarPubMed
20. Office of Population Censuses and Surveys. Table 6. Ethnic group, sex, age and district residence. Population Censuses, 1991.Google Scholar
21.Office of Population Censuses and Surveys. Table 9.4. Live births: country of birth and age of mother, 1991. Birth Statistics, FM1 Series 1991; No 20.Google Scholar
22. Health Studies Branch, Center for International Research, US Bureau of the Census. Recent seroprevalence levels by country. Research Note, June 1993; No. 9.Google Scholar
23.Gibb, DM, Faulknall, W, Nokes, L, et al. Coverage of routine neonatal metabolic screening in children born to women known to be infected with HIV-1. Communicable Disease Report, 1995; 5: R123–4.Google ScholarPubMed