Introduction
Systematic testing of pregnant women (PW) during antennal clinic is a requirement by national guidelines. Several reasons including religious belief, claims to treat HIV by traditional healers, etc contribute to some known HIV-positive people retesting for HIV. Although periodic scientific population-based surveys are conducted to determine the HIV incidence and prevalence, ongoing monitoring mostly use program data, which without thorough cleaning will be inaccurate. This study aims at demonstrating the effects of HIV systematic testing of PW and testing by known HIV-positive individuals on case identification and yield in the West, Southwest and Northwest regions of Cameroon.
Methods
This cross-sectional study used clinical tips to identify some already known HIV-positive individual who were retesting and further used the Data Manager (DAMA) software to verify all person who tested positive to ascertain that they were not already know positive on treatment by sorting and comparing using variables like name, sex, age, telephone number, etc. Further, we computed the yield excluding the data of PW from the overall testing data.
Results
From October 2023 to June 2024, a total of 135,423 individuals were tested and 4,889 were HIV-positive, representing a yield of 3.6%. After adjusting for known HIV positives who were retesting, the yield dropped to 2.7%. The yield the increased to 3.4% when the data of PW was excluded. Averagely, known HIV-positives contributed 26% to overall positives, inflating the yield by an average of 1% while the systematic testing of PW dilutes the testing yield by an average of 0.7%
Conclusion
Efforts to carefully determine a more accurate HIV testing yield are critical because it significantly contribute to programming. Identifying re-testers reduces the case identification numbers by about 26%. The use of clinical information and electronic system like DAMA are key to successfully minimizing the know positives, hence determining a more accurate yield.
