Connecting Observation to Counteractive action through Information.


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Connecting Observation to Anticipation through Information 2002 Perinatal Avoidance Grantees Meeting February 12-14, 2002 Facilitators: Norma Harris and Joann Schulte, CDC Welcomed Speakers: Linda DiMasi and Daniel Lauricelli, New Jersey Dept of Wellbeing HIV/Helps Reconnaissance 101 Session Diagram
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Connecting Surveillance to Prevention through Data 2002 Perinatal Prevention Grantees Meeting February 12-14, 2002 Facilitators: Norma Harris and Joann Schulte, CDC Invited Speakers: Linda DiMasi and Daniel Lauricelli, New Jersey Dept of Health

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HIV/AIDS Surveillance 101 Session Outline Introduction Framework for coordinated HIV/AIDS observation Critical ideas: secrecy, spread, and assessment Technical help Relevant assets Pediatric/perinatal reconnaissance

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HIV/AIDS Surveillance Definition The deliberate accumulation, examination, understanding, scattering, and assessment of populace based data about persons with analyzed HIV and AIDS.

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Public Health Surveillance Ongoing, efficient collection, investigation, and translation of information vital to the arranging, usage, and assessment of general wellbeing practice Closely coordinated with the convenient scattering to those in charge of counteractive action and control

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HIV/AIDS Surveillance How Data are Used Monitor occurrence and predominance of analyzed HIV contamination and AIDS Track HIV-related bleakness and mortality Detect patterns in HIV transmission Follow the qualities of those influenced Identify populaces at danger Estimate frequency and pervasiveness of HIV disease Target aversion exercises and assess their adequacy Allocate stores for human services and social administrations

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AZT appeared to lessen danger of perinatal transmission Protease inhibitors authorized for utilization in US Use of HAART gets to be across the board. Helps case definition extended 500,000 AIDS cases answered to CDC as of October 1995 AZT monotherapy gets to be accessible HIV recognized 100,000 AIDS cases answered to CDC starting July 1989. Serologic test for HIV counter acting agent accessible An expected 798,500 AIDS cases analyzed through 2000 AIDS case definition altered First AIDS case definition distributed Evolution of an Epidemic Estimated AIDS occurrence * through 2000, United States *Estimated from information answered to CDC through June 2001, balanced for reporting postponements .

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HIV Infection HIV presentation (kids) HIV contamination first constructive classified HIV test first CD4+ T-cell number first popular burden test first CD4+ T-cell tally <200 cells per F L AIDS-OI Death HIV/AIDS Surveillance Monitoring the Spectrum of Infection

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Local Health Dept Sources of Reports HIV/AIDS - Hospital Practitioners 9,999 Reports - Private Practitioners - Public Clinics - Laboratories Passive Reporting Active Case Finding CDC Dissemination State Health Dept - Local Bulletins - HIV/AIDS Surveillance Reports HIV/AIDS - Supplemental Reports - CDC HIV/AIDS Web Sites - Public Information Data Set - Surveillance Slide Sets HIV/AIDS Surveillance How HIV/AIDS Surveillance Works People with HIV/AIDS

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HIV/AIDS Surveillance How Data are Collected Passive reporting Health care professionals, doctor\'s facilities, centers, and labs report instances of HIV/AIDS to state and neighborhood wellbeing offices Active contacting so as to report Health division observation staff discover cases medicinal services specialists and assessing restorative records in doctor\'s facilities and facilities

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HIV/AIDS Surveillance What Data are Collected? Demographic attributes Sex, race/ethnicity, age, home Risk data Potential methods of presentation to HIV Laboratory and clinical data Virologic and immunologic status Opportunistic sicknesses analyzed Supplemental data Prescription of antiretroviral and prophylactic treatments Use of therapeutic and substance misuse treatment administrations Health protection scope

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Behavioral Surveys of High Risk Groups e.g., HITS Performance Evaluations e.g., fulfillment, convenience, exactness Assays to Estimate HIV Incidence Representative Samples Database Matches e.g., NDI, SSDI Supplemental Interviews e.g., SHAS, RECENT, Risk Sampling Medical Record Abstractions e.g., EPS, ASD, SDC HIV/AIDS Surveillance Building a Better System Methods Research and Supplemental Data Collection HIV Infection

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Name-based Name-based (Pediatric onl y) Name-to Code-based Other non-name Reporting not obliged or not yet actualized Progress Toward a National Integrated HIV/AIDS Surveillance System Status of HIV Infection Reporting as of December 2001 Washington, D.C .

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HIV/AIDS Surveillance Confidentiality of Data State and regional laws for assurance of general wellbeing information apply to HIV/AIDS information CDC obliges that HIV/AIDS case information be kept up in physically secure situations with constrained access by approved faculty State observation projects guarantee that Program prerequisites host been met Overall Responsible Gathering (ORP) has been distinguished Confidentiality strategies have been composed Patient’s and physician’s names and other individual identifiers are not sent to CDC

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HIV/AIDS Surveillance HIV/AIDS reconnaissance projects are receptive to information requirements for arranging aversion and consideration .

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Epi Profile RWCA Data HIV Prevention Indicators Quarterly Surveillance Reports HIV/AIDS Surveillance Data Requests HIV Prevention Community Planning Groups RWCA Title I Planning Councils Surveillance Staff RWCA Title II Planning Consortia Program Staff, Media, Legislators, Ad Hoc Requests

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HIV/AIDS Surveillance Dissemination of Data Surveillance Reports Epi Profiles Ryan White CARE Act Applications Grant Applications Responses to: Ad hoc Requests Media Requests Congressional/Political Inquiries

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HIV/AIDS Surveillance National Data Dissemination HIV/AIDS Surveillance Reports www.cdc.gov/hiv/surveillance.htm MMWRs www.cdc.gov/hiv/bars/mmwr.htm Slide sets www.cdc.gov/hiv/graphics.htm Prevention and treatment rules www.cdc.gov/hiv/bars/guidelines.htm Public data information set (PIDS) www.cdc.gov/programming/apids.htm CDC certainty sheets www.cdc.gov/nchstp/od/nchstp.html Presentations at gatherings and meetings Peer-checked on diary articles AIDS hotline 1-800-342-AIDS www.ashastd.org/nah.org

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HIV/AIDS Surveillance Evaluation of System Performance HIV/AIDS observation frameworks assessed for: Accuracy Completeness of case reporting Timeliness of reporting (time in the middle of determination and report) Completeness and exactness of information gathered Evaluation gives data expected to: Improve the framework Interpret examinations of information gathered Promote the best utilization of general wellbeing assets

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HIV/AIDS Surveillance Evaluation of System Performance ( cont’d ) Minimum Performance Standards Timeliness 66% reported in 6 months Completeness  85% Accuracy  5% duplication and  5% off base coordinating Completeness of danger ascertainment >85% As illustrated in: Centers for Disease Control and Prevention. CDC rules for national HIV case reconnaissance, including checking for HIV contamination and AIDS. MMWR 1999;48 (No. RR-13).

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Focus on pediatric/perinatal reconnaissance

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Perinatal Exposure/Infection Surveillance Routine perinatal observation Population-based Active case ascertainment Follow-up of uncovered babies at regular intervals to acquire HIV contamination status, AIDS and demise Match to death registry

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Pediatric/Perinatal Surveillance A subset of HIV/AIDS Surveillance Identify HIV tainted ladies who are pregnant Identify kids conceived presented to HIV Not all youngsters destined to HIV-tainted moms will be contaminated Additional data gathered on moms and kids Enhanced reconnaissance strategies (EPS) utilized as a part of 25 destinations

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Pediatric/Perinatal Methods AIDS Surveillance information – all states HIV reporting in 37 States and Territories Conduct dynamic case discovering and screen perinatally uncovered kids for HIV status, receipt of ARV, maternal HIV testing, PNC Enhanced Perinatal reconnaissance STEP EPS

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Enhanced Perinatal HIV Surveillance STEP 7 states already financed to gather information on mother-tyke sets for 1993, 1995, 1996 and 1997 Pilot extend that extended to EPS

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EPS Methods 25 locales right now subsidized Match HIV/AIDS and conception registries for conception years 1999, 2000, 2001 Review maternal HIV, pre-birth, work/conveyance, infant and pediatric records Includes states with named HIV reporting and states with non-named reporting, utilizing office based, IRB-sanction conventions

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Project Sites: Enhanced Perinatal HIV Surveillance and Perinatal HIV Prevention Chicago DC Enhanced Perinatal Surveillance (EPS) just Perinatal Prevention Project (PPP) just BOTH EPS and PPP destinations Puerto Rico

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HIV/AIDS Surveillance Know Thy Data Additional assets Recent HIV/AIDS Surveillance Reports and Supplemental Reports www.cdc.gov/hiv/surveillance.htm Recent HIV/AIDS-related MMWRs www.cdc.gov/hiv/bars/mmwr.htm Fleming PL, Wortley PM, Karon JM, De Cock KM, Janssen RS. Following the HIV scourge: current issues, future difficulties. Am J Pub Healt h 2000;90:1037-41. Karon JM, Fleming PL, Steketee RW, De Cock KM. HIV in the United States when the new century rolled over: a pestilence on the move. Am J Pub Health 2001;91:1060-8. .:tsli

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