ABSTRACT
INTRODUCTION: Mozambique has a generalized HIV epidemic, among pregnant women, HIV prevalence is estimated at 15.8% with a vertical transmission rate of 14%, more than double global targets. We evaluate electronic national health information system (SIS-MA) performance to verify if the data flow procedures met its objectives and evaluated the prevention of mother-to-child transmission (PMTCT) surveillance system to access its attributes and usefulness. METHODS: we conducted a descriptive, cross-sectional evaluation of the PMTCT surveillance system in eight facilities in Gaza and Inhambane provinces using the centers for disease control and prevention guidelines (2001). For data quality, we cross-referenced patient registries from health facilities against the SIS-MA. We also interviewed 34 health technicians, using a Likert scale, to assess the following attributes of the PMTCT surveillance system: simplicity, stability, flexibility, acceptability, timeliness and data quality, usefulness of the system and knowledge of PMTCT. RESULTS: regarding the simplicity measure, we verified that the registry books contain more than 30 variables. The system was 83% flexible in maintaining functionality with the introduction of new health facilities in the system. The completeness of the data was 50% and concordance of data from the register book and monthly reports was 89%. CONCLUSION: the PMTCT SIS-MA is useful in supporting the collection, analysis, interpretation and continuous and systematic dissemination of health data that are used to define and monitor public health policies in Mozambique. However, continued efforts are needed to improve data quality to ensure that the SIS-MA can adequately monitor the PMTCT program and contribute to reduced vertical transmission.
Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , HIV Infections/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/virology , Acquired Immunodeficiency Syndrome/transmission , Cross-Sectional Studies , Female , HIV Infections/transmission , Health Information Systems , Health Personnel/statistics & numerical data , Humans , Male , Mozambique , Population Surveillance , Pregnancy , Prevalence , Registries , Surveys and QuestionnairesABSTRACT
A diarreia causada por Cryptosporidium spp. é comum em crianças e culmina com elevadas taxas de morbi-mortalidade, sobretudo nos países em desenvolvimento. A técnica convencional para o diagnóstico de Cryptosporidium spp. é a microscopia óptica, contudo, o Ensaio de Imunoabsorção Enzimática (ELISA) também tem sido usado. O objectivo deste estudo foi de comparar a performance do ELISA (ensaio comercial) em relação a microscopia óptica na detecção de Cryptosporidium spp. em fezes diarreicas de crianças admitidas no Hospital Geral de Mavalane (HGM) de Maio de 2014 a Fevereiro de 2015. No total, 130 amostras de fezes foram testadas, primeiramente por microscopia óptica e depois por ELISA. A estatística descritiva, sensibilidade, especi cidade e valores preditivos negativo e positivo foram usados para analisar os dados.A microscopia permitiu a identi cação de Cryptosporidium spp., Entamoeba hystolitica/díspar/moshovskii, Giardia intestinalis, Ascaris lumbricóides, Trichuris trichiura e Balantidium coli. Doze (9.2%) amostras foram positivas para Cryptosporidium spp., contra 22 (16.9%) identi cadas por ELISA. Esta diferença foi estatisticamente signi cativa (p = 0.002). A frequência de detecção deste patógeno por microscopia foi maior em crianças dos 12 aos 23 meses (4.6%), enquanto por ELISA foi maior em crianças dos zero aos 11 meses. A sensibilidade do ELISA na detecção de antígenos de Cryptosporidium spp. foi de 58.3%, enquanto a especi-cidade foi de 81.4%. Os resultados encontrados ressaltam a necessidade de uma ferramenta de diagnóstico complementar tal como o ELISA, para con rmar o diagnóstico em pacientes com sinais clínicos típicos de criptosporidiose mas com resultado negativo por microscopia.
Diarrhea caused by Cryptosporidium spp. is common in children and ends with high morbidity and mortality rates, mostly in developing countries. e conventional technique for the diagnosis of Cryptosporidium spp. is the optical microscopy, however, the Enzyme-linked immunosorbent assay (ELISA) is also being implemented. e aim of this study was to compare the performance of ELISA (commercial immunoassay) in relation to optical microscopy to detect Cryptosporidium spp. in diarrheic feces of children admitted to Mavalane General Hospital from May 2014 to February 2015. Overall 130 stool samples were tested rstly by optical microscopy and then by ELISA. Descriptive statistics, sensitivity, speci city, negative and positive predictive value were used to analyze the data. e microscopy detected 12 (9.2%) Cryptosporidiumspp., positive samples and ELISA identi ed 22 (16.9%). is di erence was statistically signi cant (p = 0.002). e frequency of detection by microscopy was higher in children from 12 to 23 months (4.6%), while by ELISA was higher in those from zero to 11 months. e microscopy enabled the identi cation of other parasites such as Entamoeba hystolitica/díspar/moshovskii, Giardia intestinalis, Ascaris lumbricóides, Trichuris trichiura and Balantidium coli. e sensitivity of the ELISA in detection of Cryptosporidium spp. antigens was 58.3%, while the speci city was 81.4%. Taking all together, our results highlight the need of a complementary diagnostic tool, such as this ELISA, to con rm the diagnosis in patients with typical clinicalsymptoms of cryptosporidiosis but negative results by microscopy.
